Active NPI
Paula L McDonald, R.PH
- Pharmacist
- Wahpeton, ND
National Provider Identifier
1306893052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4400
- Practice address
- 387 11TH St S
Wahpeton, ND 58075-4653 - Phone
- (701) 642-2336
- Fax
- (701) 642-1470
- NPI assigned
- May 28, 2006
- Last updated
- Nov 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4400 | ND | Primary |
Addresses
Primary practice location
387 11TH St S
Wahpeton, ND 58075-4653
Mailing address
7746 Marie St
Wahpeton, ND 58075-9628
Phone (701) 640-2745
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 091062700 | Medicaid | MN | |
| 9167120 | Medicaid | SD | |
| 21128 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4400 | ND | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southtown Econodrug | Current | Accepting new patients | |
| Southtown Econodrug, Inc. | Current | Accepting new patients |
Locations
387 11th St S
Wahpeton, ND 58075
Phone (701) 642-2336
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Wahpeton, ND
- NPI 1710977897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1306893052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7746 MARIE ST",
"city": "WAHPETON",
"state": "ND",
"postal_code": "580759628",
"telephone_number": "701-640-2745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "387 11TH ST S",
"city": "WAHPETON",
"state": "ND",
"postal_code": "580754653",
"telephone_number": "701-642-2336",
"fax_number": "701-642-1470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "PAULA",
"middle_name": "L",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-28",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ND",
"license": "4400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "091062700",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9167120",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "21128",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wahpeton, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.