Healthcare Provider Details

I. General information

NPI: 1487594263
Provider Name (Legal Business Name): CENTRAL RX GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 N MAIN ST
BOWMAN ND
58623-4022
US

IV. Provider business mailing address

990 MAIN ST
CARRINGTON ND
58421-2024
US

V. Phone/Fax

Practice location:
  • Phone: 701-523-3233
  • Fax:
Mailing address:
  • Phone: 701-652-5810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHANE WENDEL
Title or Position: PARTNER
Credential:
Phone: 701-652-5810