Healthcare Provider Details

I. General information

NPI: 1801052592
Provider Name (Legal Business Name): THREE AFFILIATED TRIBES PARSHALL HEALTHCARE TELE-PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 3RD ST SE
PARSHALL ND
58770
US

IV. Provider business mailing address

PO BOX 145
PARSHALL ND
58770-0145
US

V. Phone/Fax

Practice location:
  • Phone: 701-862-8220
  • Fax: 701-862-4820
Mailing address:
  • Phone: 701-862-8220
  • Fax: 701-862-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number776
License Number StateND

VIII. Authorized Official

Name: DONNA BIERI
Title or Position: CHIEF TELEPHARMACIST
Credential:
Phone: 701-938-3459