Healthcare Provider Details

I. General information

NPI: 1609908631
Provider Name (Legal Business Name): AASEN DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MAIN ST E
MAYVILLE ND
58257-1435
US

IV. Provider business mailing address

15 MAIN ST E
MAYVILLE ND
58257-1435
US

V. Phone/Fax

Practice location:
  • Phone: 701-788-2552
  • Fax: 701-788-2340
Mailing address:
  • Phone: 701-788-2552
  • Fax: 701-788-2340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHAR64
License Number StateND

VIII. Authorized Official

Name: MARCUS AASEN
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 701-788-2552