Active NPI
Dillon Jerome Boe, RPH
- Pharmacist
- Fargo, ND
National Provider Identifier
1508430992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH6277
- Practice address
- 2425 13TH Ave S
Fargo, ND 58103-3749 - Phone
- (701) 232-4872
- NPI assigned
- May 19, 2021
- Last updated
- May 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | RPH6277 | ND | Primary |
Addresses
Primary practice location
2425 13TH Ave S
Fargo, ND 58103-3749
Mailing address
2425 13TH Ave S
Fargo, ND 58103-3749
Phone (701) 232-4872
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 |
|---|---|---|---|
| RPH6277 | ND | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Acres Pharmacy Inc | Past | Accepting new patients | |
| American Drug Stores Delaware LLC | Past | Accepting new patients | |
| American Drug Stores Delaware LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1508430992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 13TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581033749",
"telephone_number": "701-232-4872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 13TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581033749",
"telephone_number": "701-232-4872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOE",
"first_name": "DILLON",
"middle_name": "JEROME",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-19",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ND",
"license": "RPH6277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
- Daisy Boatey
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- Body Works Physical Therapy, LTD. (Bodyworks Physical Therapy)
- Body Works Physical Therapy, LTD. (Bliss Massage Therapy)
- Angela Mae Boe, LSW
- Julie Rebecca Boe, CRNA
- Jennifer Ann Boeckel, MSW, LCSW
- Tasha Lee Boehland, DIPL.AC
- Brittani Rose Boehlke-Fiecke, PA-C
- Caleb J Boehm, RBT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.