MEDICARE: MRS. CAROL M SELZLER RPH

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
1	183500000X	Pharmacist	4850	ND

General Provider Information

NPI Number	:	1710286216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL M SELZLER RPH

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	:	701-324-2295

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	:	701-324-2295

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	03/23/2011

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