Healthcare Provider Details

I. General information

NPI: 1275569790
Provider Name (Legal Business Name): CARRINGTON DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 03/07/2023
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MAIN ST
CARRINGTON ND
58421-1671
US

IV. Provider business mailing address

415 MAIN ST
CARRINGTON ND
58421-1671
US

V. Phone/Fax

Practice location:
  • Phone: 701-652-2521
  • Fax: 701-652-2326
Mailing address:
  • Phone: 701-652-2521
  • Fax: 701-652-2326

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 Number162
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number162
License Number StateND

VIII. Authorized Official

Name: MR. MATTHEW JAY PAULSON
Title or Position: OWNER
Credential: R.PH.
Phone: 701-652-2521