Organization
WEST ACRES PHARMACY INC
Active
Other names
WEST ACRES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY LOBERG (MANAGER AND PARTNER)
(701) 282-0285
Entity
Organization
Contact information
Practice address
3902 13TH AVE S, STE 3706, FARGO, ND 58103-3357
(701) 282-0285
(701) 281-2728
Mailing address
3902 13TH AVE S, STE 3706, FARGO, ND 58103-3357
(701) 282-0285
(701) 281-2728
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR113
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2071325
PK
—
05
—
20857
—
ND
05
—
878057900
—
MN
Enumeration date
03/05/2007
Last updated
06/19/2015
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