Healthcare Provider Details

I. General information

NPI: 1982927406
Provider Name (Legal Business Name): WALLS LTC PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 8TH AVE S
GRAND FORKS ND
58201
US

IV. Provider business mailing address

1322 8TH AVE S
GRAND FORKS ND
58201-4354
US

V. Phone/Fax

Practice location:
  • Phone: 701-738-0804
  • Fax: 701-738-0406
Mailing address:
  • Phone: 701-738-0804
  • Fax: 701-738-0806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LESLIE SATTERLUND
Title or Position: OWNER/SECRETARY
Credential: RPH
Phone: 701-738-0804