Healthcare Provider Details

I. General information

NPI: 1700552528
Provider Name (Legal Business Name): HOVDE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 41ST AVE S
MOORHEAD MN
56560-7426
US

IV. Provider business mailing address

1610 41ST AVE S
MOORHEAD MN
56560-7426
US

V. Phone/Fax

Practice location:
  • Phone: 701-277-5263
  • Fax:
Mailing address:
  • Phone: 701-277-5263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TERESA ANN HOVDE
Title or Position: OWNER
Credential:
Phone: 701-277-5263