Healthcare Provider Details

I. General information

NPI: 1720527120
Provider Name (Legal Business Name): NORTH HILL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 LANDMARK CIR NW STE C
MINOT ND
58703
US

IV. Provider business mailing address

PO BOX 10
VELVA ND
58790-0010
US

V. Phone/Fax

Practice location:
  • Phone: 701-720-6187
  • Fax:
Mailing address:
  • Phone: 701-720-6187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHAR565
License Number StateND

VIII. Authorized Official

Name: TRACY KRUEGER
Title or Position: OWNER
Credential:
Phone: 701-720-6187