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General NPI Number Information
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NPI Number | 1407038532
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Entity Type | Organization
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Legal Business Name | LG MEADOWS INC
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 431 W VILLARD ST
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City | DICKINSON
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State | ND
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Zip | 58601-5016
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Country | US
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Telephone | 701-227-8265
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Fax | 701-227-8289
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Provider Business Mailing Address
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Address Line | 431 W VILLARD ST
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City | DICKINSON
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State | ND
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Zip | 58601-5016
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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 | OWNER
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Name | MR. LAREN G MEADOWS
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Credential | RPH
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Telephone | 701-227-8265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | ND
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