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NPI Code Detail

MEDICARE: CHERNUGAL INC

MEDICARE: CHERNUGAL 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
13336C0004XCompounding Pharmacy
2333600000XPharmacy
3332B00000XDurable Medical Equipment & Medical Supplies
43336C0003XCommunity/Retail Pharmacy259951MN

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
32046085OTHERPK

General Provider Information

NPI Number : 1467458323
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHERNUGAL INC
Provider Business Mailing Address
First Line : 217 PAUL BUNYAN DR NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-2433
Country : US
Telephone Number : 218-759-1222
Fax Number : 218-759-0859
Provider Business Practice Location Address
First Line : 217 PAUL BUNYAN DR NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-2433
Country : US
Telephone Number : 218-759-1222
Fax Number : 218-444-5292
Authorized Official
Title or Position : OWNER AND PRES
Name : RICHARD CHERUNUGAL
Credential : RPH
Telephone Number : 218-759-1222
Provider Enumeration Date : 06/24/2005
Last Update Date : 12/07/2016

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Directions to “CHERNUGAL INC ” Practice Location

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