Healthcare Provider Details
I. General information
NPI: 1326353160
Provider Name (Legal Business Name): SEIP DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2010
Last Update Date: 09/19/2025
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
316 MN HIGHWAY 78 N STE 100
OTTERTAIL MN
56571-7035
US
IV. Provider business mailing address
316 MN HIGHWAY 78 N STE 100
OTTERTAIL MN
56571-7035
US
V. Phone/Fax
- Phone: 218-367-2196
- Fax: 218-367-2197
- Phone: 218-367-2196
- Fax: 218-367-2197
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336M0002X |
| Taxonomy | Mail Order Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 263575 |
| License Number State | MN |
VIII. Authorized Official
Name:
NATHAN
SEIP
Title or Position: CHIEF MANAGER
Credential:
Phone: 218-640-2722