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General NPI Number Information
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NPI Number | 1396723797
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Entity Type | Organization
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Legal Business Name | PRESCRIPTION CENTER PHARMACY INC.
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 2400 32ND AVE S
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City | FARGO
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State | ND
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Zip | 58103-5800
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Country | US
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Telephone | 701-234-9912
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Fax | 701-297-0807
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Provider Business Mailing Address
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Address Line | 2400 32ND AVE S
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City | FARGO
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State | ND
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Zip | 58103-5800
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Country | US
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Telephone | 701-234-9912
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Fax | 701-297-0807
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY DOUGLAS JACOBSON
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Credential |
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Telephone | 701-238-0395
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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 | 1
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License Number State | ND
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