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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