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General NPI Number Information
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NPI Number | 1730177510
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Entity Type | Organization
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Legal Business Name | CASSELTON DRUG INC.
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 622 FRONT ST
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City | CASSELTON
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State | ND
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Zip | 58012-3300
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Country | US
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Telephone | 701-347-4281
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Fax | 701-347-5275
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Provider Business Mailing Address
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Address Line | PO BOX 250
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City | CASSELTON
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State | ND
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Zip | 58012-0250
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Country | US
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Telephone | 701-347-4281
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Fax | 701-347-5275
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Authorized Official
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Title or Position | OWNER
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Name | KATHLEEN NELSON
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Credential |
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Telephone | 701-347-4281
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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 | 230
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License Number State | ND
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