NPIMap

Organization Active NPI

Edgeley Pharmacy LLC

Doing business as Edgeley Pharmacy

  • Community/Retail Pharmacy
  • Edgeley, ND
National Provider Identifier
1548566698
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
717 Issued in ND
Legal business name
EDGELEY PHARMACY LLC
Doing business as
Edgeley Pharmacy
Practice address
503 Main St
Ste B
Edgeley, ND 58433-7119
Phone
(701) 493-2810
Fax
(701) 493-2263
NPI assigned
Feb 8, 2011
Last updated
Jun 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Authorized official

Name
Dr. Daniel Moore Churchill, PHARM. D.NPI 1740300110
Title
President
Phone
(701) 224-0339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 717 ND Primary
Long Term Care Pharmacy 3336L0003X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

503 Main St
Ste B
Edgeley, ND 58433-7119

Mailing address

PO Box 25
Edgeley, ND 58433-0025
Phone (701) 493-2810

Other identifiers 1

IdentifierTypeStateIssuer
1499371MedicaidND

Other names 1

  • Edgeley Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Churchill Pharmacy Holding4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

503 Main St
Ste B
Edgeley, ND 58433
Phone (701) 493-2810

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1548566698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25",
            "city": "EDGELEY",
            "state": "ND",
            "postal_code": "584330025",
            "telephone_number": "701-493-2810",
            "fax_number": "701-493-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 MAIN ST",
            "address_2": "STE B",
            "city": "EDGELEY",
            "state": "ND",
            "postal_code": "584337119",
            "telephone_number": "701-493-2810",
            "fax_number": "701-493-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGELEY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "CHURCHILL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-224-0339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ND",
            "license": "717",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1499371",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgeley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edgeley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgeley, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.