Healthcare Provider Details

I. General information

NPI: 1740249929
Provider Name (Legal Business Name): LAMOURE DRUG STORE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 1ST AVE SW
LAMOURE ND
58458-7415
US

IV. Provider business mailing address

PO BOX 175
LAMOURE ND
58458-0175
US

V. Phone/Fax

Practice location:
  • Phone: 701-883-5339
  • Fax: 701-883-5531
Mailing address:
  • Phone: 701-883-5339
  • Fax: 701-883-5531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHAR150
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHAR150
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHAR150
License Number StateND
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHAR150
License Number StateND

VIII. Authorized Official

Name: ALICIA R LAUF
Title or Position: OWNER
Credential: RPH
Phone: 701-883-5339