Organization
MEDICAL PHARMACY INC
Active
Other names
MEDICAL PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD NELSON (PRES)
(701) 237-0322
Entity
Organization
Contact information
Practice address
100 4TH ST S, FARGO, ND 58103-1929
(701) 237-0322
(701) 237-0417
Mailing address
100 4TH ST S, FARGO, ND 58103-1929
(701) 237-0322
(701) 237-0417
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR48
ND
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20397
—
ND
01
—
2070738
PK
—
Enumeration date
12/14/2006
Last updated
01/18/2017
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