Organization
ELLENDALE PHARMACY INC
Active
Other names
Ellendale Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY ULMER (PRESIDENT)
(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
3336C0003X
Community/Retail Pharmacy
Primary
PHAR535
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158114
PK
—
Enumeration date
03/02/2016
Last updated
08/10/2016
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