Healthcare Provider Details

I. General information

NPI: 1528288834
Provider Name (Legal Business Name): ALLISON R FRANK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MERITCARE KIDNEY DIALYSIS UNIT 1717 SOUTH UNIVERSITY DRIVE
FARGO ND
58122-0334
US

IV. Provider business mailing address

4283 42ND AVE S
FARGO ND
58104-3915
US

V. Phone/Fax

Practice location:
  • Phone: 701-280-4497
  • Fax: 701-280-4490
Mailing address:
  • Phone: 701-433-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4662
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number116435
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: