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General NPI Number Information
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NPI Number | 1558376152
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Entity Type | Organization
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Legal Business Name | ND PHARMACY INC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 20 26TH ST E
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City | WILLISTON
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State | ND
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Zip | 58801-3046
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Country | US
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Telephone | 701-572-4181
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Fax | 701-572-0921
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Provider Business Mailing Address
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Address Line | 20 26TH ST E
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City | WILLISTON
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State | ND
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Zip | 58801-3046
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Country | US
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Telephone | 701-572-4181
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Fax | 701-572-0921
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT TREITLINE
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Credential | RPH
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Telephone | 701-225-4434
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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 |
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License Number State |
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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 | 39
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License Number State | ND
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