Organization
HAZEN HEALTH PHARMACY
Active
Parent organization
BEULAH DRUG COMPANY
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEULAH DRUG COMPANY
Authorized official
WYATT ELDON MARTENSON PHARMD (OWNER/PRESIDENT)
(701) 873-5215
Entity
Organization
Contact information
Practice address
30 MAIN ST W, HAZEN, ND 58545-4205
(701) 748-2312
(701) 748-2637
Mailing address
PO BOX 669, HAZEN, ND 58545-0669
(701) 748-2312
(701) 748-2637
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
10/17/2022
Last updated
10/18/2022
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