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General NPI Number Information
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NPI Number | 1063587277
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Entity Type | Individual
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Provider Name | JULIE M BUBACH RPH
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Gender | Female
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3000 32ND AVE S
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City | FARGO
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State | ND
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Zip | 58103-6132
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Country | US
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Telephone | 701-364-8140
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Fax | 701-364-8157
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Provider Business Mailing Address
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Address Line | 8008 SAGITTARIUS CIR
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City | FARGO
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State | ND
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Zip | 58104-7907
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Country | US
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Telephone | 701-298-0941
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Fax | 701-364-8157
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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 | ND 4427
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License Number State | ND
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