Healthcare Provider Details

I. General information

NPI: 1336477223
Provider Name (Legal Business Name): CHAMBERZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 LINCOLN AVE
HARVEY ND
58341
US

IV. Provider business mailing address

PO BOX 325
HARVEY ND
58341-0325
US

V. Phone/Fax

Practice location:
  • Phone: 701-324-2227
  • Fax: 701-324-4754
Mailing address:
  • Phone: 701-324-2227
  • Fax: 701-324-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateND

VIII. Authorized Official

Name: CHAD WAYNE ZIEGLER
Title or Position: OWNER
Credential:
Phone: 701-324-2227