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YE OLDE MEDICINE SHOPPE NPI 1720020324


NPI Information

NPI: 1720020324
Provider Name: YE OLDE MEDICINE SHOPPE

Doing Business As: YE OLDE MEDICINE CENTER

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
503 PARK ST W
PARK RIVER, ND
ZIP 58270
Phone: (701) 284-7676
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YE OLDE MEDICINE SHOPPE is a community/retail pharmacy pharmacy in Park River, ND. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. YE OLDE MEDICINE SHOPPE NPI is 1720020324. The provider is registered as an organization entity type.
The provider Is Doing Business As Ye Olde Medicine Center.

The provider's business location address is:

503 PARK ST W
PARK RIVER, ND
ZIP 58270-137
Phone: (701) 284-7676
Fax: (701) 284-6129

The provider's authorized official is Laurie Larson .
The authorized official title is Presdient and has the following contact phone number (701) 284-7676.

The enumeration date for this NPI number is 6/11/2006 and was last updated on 7/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336L0003XPharmacyLong Term Care PharmacyNo
43336C0003XPharmacyCommunity/Retail PharmacyPHAR59NORTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12071194OTHERPK
220668MEDICAIDNORTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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