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NPI Code Detail

MEDICARE: PRESCRIPTION CENTER PHARMACY INC.

MEDICARE: PRESCRIPTION CENTER PHARMACY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy1ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

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

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Directions to “PRESCRIPTION CENTER PHARMACY INC. ” Practice Location

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