MEDICARE: HANKINSON DRUG INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy
2	3336C0004X	Compounding Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	3336M0003X	Managed Care Organization Pharmacy
5	333600000X	Pharmacy
6	3336C0003X	Community/Retail Pharmacy	PHAR4	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2070830	OTHER	PK
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801900881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANKINSON DRUG INC

Provider Business Mailing Address
First Line	:	PO BOX 160
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041-0160
Country	:	US
Telephone Number	:	701-242-7414
Fax Number	:	701-242-7173

Provider Business Practice Location Address
First Line	:	323 MAIN AVE S
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041-4100
Country	:	US
Telephone Number	:	701-242-7414
Fax Number	:	701-242-7173

Authorized Official
Title or Position	:	OWNER, PRESIDENT, PIC
Name	:	JULIE FALK
Credential	:	PHARMD
Telephone Number	:	701-242-7414

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	10/31/2016

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Directions to “HANKINSON DRUG INC ” Practice Location

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