Organization
LARSEN SERVICE DRUG INC
Active
Organization
LARSEN SERVICE DRUG INC
Active
Other names
LARSEN SERVICE DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LARSEN RPH (PRESIDENT AND OWNER)
(701) 444-2410
Entity
Organization
Contact information
Practice address
244 N MAIN ST, WATFORD CITY, ND 58854-7122
(701) 444-2410
(701) 444-2921
Mailing address
PO BOX 550, WATFORD CITY, ND 58854-0550
(701) 444-2410
(701) 444-2921
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR163
ND
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020166
—
ND
01
—
2071165
PK
—
Enumeration date
06/20/2006
Last updated
02/23/2016
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