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General NPI Number Information
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NPI Number | 1053920272
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Entity Type | Individual
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Provider Name | EMILY MARIN MADSEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 1500 14TH ST W STE 150
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City | WILLISTON
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State | ND
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Zip | 58801-4080
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Country | US
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Telephone | 701-572-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 14TH ST W STE 150
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City | WILLISTON
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State | ND
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Zip | 58801-4080
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Country | US
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Telephone | 701-572-7979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA-PHA-LIC-71031
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH6278
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License Number State | ND
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