Organization Active NPI

Ollerman Inc

Doing business as The Medicine Shoppe Pharmacy

  • Community/Retail Pharmacy
  • Dickinson, ND
National Provider Identifier
1043504574
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHAR327 Issued in ND
Legal business name
OLLERMAN INC
Doing business as
The Medicine Shoppe Pharmacy
Practice address
1571 W Villard St Ste 1
Dickinson, ND 58601-4656
Phone
(701) 227-8265
Fax
(701) 227-8289
NPI assigned
Jun 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandi OllermanNPI 1932134426
Title
Owner
Phone
(701) 227-8265

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHAR327 ND Primary

Addresses

Primary practice location

1571 W Villard St Ste 1
Dickinson, ND 58601-4656

Mailing address

1571 W Villard St Ste 1
Dickinson, ND 58601-4656
Phone (701) 227-8265

Other identifiers 2

IdentifierTypeStateIssuer
1455403MedicaidND
2131219OtherPK

Other names 1

  • The Medicine Shoppe Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110914000032 ND Part B Supplier - Pharmacy 0941471460 Practice locations: Dickinson, ND
O20111019000406 ND DME Supplier - Pharmacy 0941471460 Practice locations: Dickinson, ND

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D2135199Medicine Shoppe Pharmacy1571 W Villard, Dickinson, ND 58601Certificate of waiverAug 15, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Medicine Shoppe1571 W Villard, Dickinson, ND 58601(701) 227-8265 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Re… Accepts assignmentParticipating since Jun 8, 2011

National Provider Directory

National Provider Directory

Locations

1571 W Villard St
Ste 1
Dickinson, ND 58601
Phone (701) 227-8265

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1043504574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 W VILLARD ST STE 1",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014656",
            "telephone_number": "701-227-8265",
            "fax_number": "701-227-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 W VILLARD ST STE 1",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014656",
            "telephone_number": "701-227-8265",
            "fax_number": "701-227-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLLERMAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-01",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "OLLERMAN",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-227-8265"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ND",
            "license": "PHAR327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455403",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.