Healthcare Provider Details

I. General information

NPI: 1538262654
Provider Name (Legal Business Name): ASHLEY DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 W MAIN ST
ASHLEY ND
58413
US

IV. Provider business mailing address

PO BOX 70
ASHLEY ND
58413-0070
US

V. Phone/Fax

Practice location:
  • Phone: 701-288-3355
  • Fax: 701-288-3394
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number92
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DALLAS LANG
Title or Position: PRESIDENT
Credential:
Phone: 701-288-3355