Healthcare Provider Details

I. General information

NPI: 1285651984
Provider Name (Legal Business Name): PHARMACISTS ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 OHMER ST
BOTTINEAU ND
58318-1045
US

IV. Provider business mailing address

314 OHMER ST
BOTTINEAU ND
58318-1045
US

V. Phone/Fax

Practice location:
  • Phone: 701-228-2220
  • Fax: 701-228-5827
Mailing address:
  • Phone: 701-228-2220
  • Fax: 701-228-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number653
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHAR653
License Number StateND

VIII. Authorized Official

Name: MR. LYLE LUTMAN
Title or Position: OWNER
Credential: RPH
Phone: 701-256-3330