Healthcare Provider Details

I. General information

NPI: 1871790535
Provider Name (Legal Business Name): PAMELA KRIVARCHKA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 3RD ST
LANGDON ND
58249-2625
US

IV. Provider business mailing address

PO BOX 465
LANGDON ND
58249-0465
US

V. Phone/Fax

Practice location:
  • Phone: 701-256-3330
  • Fax:
Mailing address:
  • Phone: 701-799-3154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5123
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: