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General NPI Number Information
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NPI Number | 1093841496
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Entity Type | Organization
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Legal Business Name | THEIGE DRUG INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1395 S COLUMBIA RD SUITE C
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City | GRAND FORKS
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State | ND
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Zip | 58201-4054
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Country | US
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Telephone | 701-746-1800
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Fax | 701-746-4040
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Provider Business Mailing Address
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Address Line | 1395 S COLUMBIA RD SUITE C
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City | GRAND FORKS
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State | ND
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Zip | 58201-4054
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Country | US
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Telephone | 701-746-1800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFF THEIGE
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Credential | RPH
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Telephone | 701-746-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 332
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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