Healthcare Provider Details

I. General information

NPI: 1417968074
Provider Name (Legal Business Name): PHARMACISTS ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MAIN ST N
LAKOTA ND
58344-7105
US

IV. Provider business mailing address

PO BOX 309
LAKOTA ND
58344-0309
US

V. Phone/Fax

Practice location:
  • Phone: 701-247-2781
  • Fax: 701-247-2643
Mailing address:
  • Phone: 701-247-2781
  • Fax: 701-247-2643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number867
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHAR867
License Number StateND

VIII. Authorized Official

Name: SHANE WENDEL
Title or Position: PARTNER
Credential:
Phone: 701-652-2651