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General NPI Number Information
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NPI Number | 1205904109
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Entity Type | Organization
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Legal Business Name | JORGENSON DRUG INC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 148 MAIN ST
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City | ROUNDUP
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State | MT
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Zip | 59072-2830
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Country | US
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Telephone | 406-323-1811
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Fax | 406-323-1621
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Provider Business Mailing Address
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Address Line | 148 MAIN ST
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City | ROUNDUP
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State | MT
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Zip | 59072-2830
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRES OWNER
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Name | SHEILA SODERBERG
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Credential | RPH
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Telephone | 406-323-1811
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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 | 763
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License Number State | MT
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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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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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