Organization
GLEN ULLIN PHARMACY LLC
Active
Other names
Glen Ullin Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL MOORE CHURCHILL PHARMD (PRESIDENT)
(701) 224-0339
Entity
Organization
Contact information
Practice address
113 S MAIN ST, GLEN ULLIN, ND 58631-7101
(701) 348-3303
(701) 348-3913
Mailing address
PO BOX 636, GLEN ULLIN, ND 58631-0636
(701) 348-3303
(701) 348-3913
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
789
ND
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153034
PK
—
Enumeration date
12/19/2007
Last updated
09/02/2022
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