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General NPI Number Information
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NPI Number | 1871503722
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Entity Type | Organization
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Legal Business Name | SEIP DRUG LLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 124 2ND AVE WEST
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City | BERTHA
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State | MN
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Zip | 56437
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Country | US
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Telephone | 218-924-2124
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Fax | 218-924-2129
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Provider Business Mailing Address
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Address Line | PO BOX 157
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City | BERTHA
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State | MN
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Zip | 56437-0157
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Country | US
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Telephone | 218-849-2124
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Fax | 218-849-2129
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Authorized Official
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Title or Position | CHIEF MANAGER
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Name | NATHAN SEIP
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Credential |
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Telephone | 218-640-2722
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 263523
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License Number State | MN
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