Organization
LISBON PHARMACY INC
Active
Other names
LISBON SHEYENNE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS BUCHHOLZ (PRES)
(701) 683-4691
Entity
Organization
Contact information
Practice address
404 MAIN ST, LISBON, ND 58054-4142
(701) 683-4691
(701) 683-4550
Mailing address
PO BOX 113, LISBON, ND 58054-0113
(701) 683-4691
(701) 683-4550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
308
ND
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020104
—
ND
01
—
3502970
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/14/2006
Last updated
07/21/2010
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