Healthcare Provider Details

I. General information

NPI: 1336421551
Provider Name (Legal Business Name): JAMIE L ZIEBARTH PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 MAIN STREET
TURTLE LAKE ND
58575
US

IV. Provider business mailing address

PO BOX 70
TURTLE LAKE ND
58575-0070
US

V. Phone/Fax

Practice location:
  • Phone: 701-448-2542
  • Fax: 701-448-2550
Mailing address:
  • Phone: 701-448-2542
  • Fax: 701-448-2550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5391
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: