Organization
PRESCRIPTION CENTER PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DOUGLAS JACOBSON (PRESIDENT)
(701) 234-9912
Entity
Organization
Contact information
Practice address
2701 13TH AVE S, FARGO, ND 58103-3602
(701) 234-3630
(701) 234-3631
Mailing address
2701 13TH AVE S, FARGO, ND 58103-3602
(701) 234-3630
(701) 234-3631
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
02
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20829
—
ND
Enumeration date
10/25/2006
Last updated
01/28/2021
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