Individual
TINA A GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1 MAIN STREET, BELCOURT, ND 58316
(701) 477-6111
(701) 477-2524
Mailing address
1 MAIN STREET, BELCOURT, ND 58316
(701) 477-6111
(701) 477-2524
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH5502
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH5502
ND PHARMACIST LICENSE NUMBER
ND
Enumeration date
03/14/2013
Last updated
03/14/2013
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