Organization
THOMAS ULMER
Active
Other names
ELLENDALE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS ULMER (OWNER)
(701) 349-3390
Entity
Organization
Contact information
Practice address
117 MAIN ST, ELLENDALE, ND 58436-7101
(701) 349-3390
(701) 349-3052
Mailing address
PO BOX 780, ELLENDALE, ND 58436-0780
(701) 349-3390
(701) 349-3052
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR17
ND
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20043
—
ND
01
—
2070813
PK
—
Enumeration date
02/16/2007
Last updated
07/31/2013
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