Organization Active NPI

Western Dakota Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Williston, ND
National Provider Identifier
1205923406
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WESTERN DAKOTA PHARMACY, INC.
Practice address
1102 Main St
Williston, ND 58801-4233
Phone
(701) 572-7797
Fax
(701) 572-0937
NPI assigned
Oct 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Gerald Gratz, RPH
Title
President
Phone
(701) 572-7797

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 51 ND
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1102 Main St
Williston, ND 58801-4233

Mailing address

PO Box 640
Williston, ND 58802-0640

Other identifiers 2

IdentifierTypeStateIssuer
3501930OtherOTHER ID NUMBER-COMMERCIAL NUMBER
20176MedicaidND

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1205923406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588020640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 MAIN ST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588014233",
            "telephone_number": "701-572-7797",
            "fax_number": "701-572-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DAKOTA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GRATZ",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-572-7797",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ND",
            "license": "51",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3501930",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20176",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.