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Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICK THOMAS PHARMD (PHARMACIST)
(701) 595-6092
Entity
Organization

Contact information

Practice address
310 SHADY LN, MANDAN, ND 58554-3828
(701) 595-6092
Mailing address
310 SHADY LN, MANDAN, ND 58554-3828
(701) 595-6092

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5027
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1316147127
NPI
ND
Enumeration date
04/12/2017
Last updated
04/12/2017
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