Healthcare Provider Details
I. General information
NPI: 1417945080
Provider Name (Legal Business Name): FORMAN DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2005
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
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
- Phone: 701-724-6222
- Fax: 701-724-3842
- Phone: 701-724-6222
- Fax: 701-724-3842
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PHAR19 |
| License Number State | ND |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NATHAN
SCHLECHT
Title or Position: OWNER
Credential: RPH
Phone: 701-724-6222