Healthcare Provider Details

I. General information

NPI: 1780962126
Provider Name (Legal Business Name): HEART OF AMERICA CLINIC PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 10/01/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 HIGHWAY 2 E # 101
RUGBY ND
58368-7801
US

IV. Provider business mailing address

2975 HIGHWAY 2 E # 101
RUGBY ND
58368-7801
US

V. Phone/Fax

Practice location:
  • Phone: 701-776-2531
  • Fax: 701-776-6280
Mailing address:
  • Phone: 701-776-2531
  • Fax: 701-776-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TALLIE SCHNEIDER
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 701-776-2531