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NPI Code Detail

MEDICARE: SEARS ENTERPRISES LLC

MEDICARE: SEARS ENTERPRISES LLC
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
13336C0003XCommunity/Retail Pharmacy216ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13503566OTHERNDNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568485431
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEARS ENTERPRISES LLC
Provider Business Mailing Address
First Line : 722 LINCOLN AVE
Second Line :
City : HARVEY
State : ND
Zip : 58341-1520
Country : US
Telephone Number : 701-324-2295
Fax Number :
Provider Business Practice Location Address
First Line : 722 LINCOLN AVE
Second Line :
City : HARVEY
State : ND
Zip : 58341-1520
Country : US
Telephone Number : 701-324-2295
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOHN R SEARS
Credential :
Telephone Number : 701-324-2295
Provider Enumeration Date : 07/25/2006
Last Update Date : 03/07/2023

Similar Medicare Providers

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1255315792 — DR. STEVEN CHARLES KOURAJIAN O.D.
Practice Location Address:
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Directions to “SEARS ENTERPRISES LLC ” Practice Location

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