Organization
MEDICAL PHARMACY MOORHEAD INC
Active
Other names
MEDICAL PHARMACY MOORHEAD AZOOL
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA NUDELL (PRESIDENT AND MANAGER)
(218) 233-7365
Entity
Organization
Contact information
Practice address
950 40TH AVE S, MOORHEAD, MN 56560-6170
(218) 359-4007
(218) 359-4010
Mailing address
950 40TH AVE S, MOORHEAD, MN 56560-6170
(218) 359-4007
(218) 359-4010
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
265281
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457747164
—
MN
01
—
2168164
PK
—
Enumeration date
04/09/2015
Last updated
07/19/2018
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