Healthcare Provider Details

I. General information

NPI: 1427046093
Provider Name (Legal Business Name): NATHAN WILBUR SCHLECHT R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MAIN ST S
FORMAN ND
58032-4001
US

IV. Provider business mailing address

PO BOX 35
FORMAN ND
58032-0035
US

V. Phone/Fax

Practice location:
  • Phone: 701-724-6222
  • Fax: 701-724-3842
Mailing address:
  • Phone: 701-724-6222
  • Fax: 701-724-3842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4646
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00018604
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: