Larsen Service Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR163 Issued in ND

Legal business name

LARSEN SERVICE DRUG INC

Practice address

244 N Main St
Watford City, ND 58854-7122

Phone

(701) 444-2410

Fax

(701) 444-2921

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Larry Larsen, RPHNPI 1760685614

Title

President and Owner

Phone

(701) 444-2410

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• LARSEN SERVICE DRUG INC Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Larsen Service Drug, Inc.

  • Community/Retail Pharmacy
  • New Town, ND
  • NPI 1093891095

  O20201023000272

  Same enrollment

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

CLIA laboratory certificates

Practitioners 5

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

• Larry C. Larsen, R.PH.

  • Pharmacist
  • Watford City, ND
  • NPI 1760685614
  NPD (past) Authorized official
• Karley J Lantz, PHARMD

  • Pharmacist
  • Trenton, ND
  • NPI 1942975974
  NPD (past)
• Kelsey Nicole Linseth, PHARM D

  • Pharmacist
  • Watford City, ND
  • NPI 1144654815
  NPD (past)
• Faith Stenberg

  • Pharmacist
  • Watford City, ND
  • NPI 1528370079
  NPD (past)
• Jenna M Wahlstrom, PHARMD

  • Pharmacist
  • Watford City, ND
  • NPI 1144668104
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1568408581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588540550",
            "telephone_number": "701-444-2410",
            "fax_number": "701-444-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 N MAIN ST",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547122",
            "telephone_number": "701-444-2410",
            "fax_number": "701-444-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARSEN SERVICE DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "701-444-2410",
        "authorized_official_credential": "RPH"
    },
    "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": "PHAR163",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020166",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2071165",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LARSEN SERVICE DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Phyllis Jones-Hjelden, OD
• Jade Alexis Kelling
• Valery Kirby
• Amy Lynn Klein, D.C.
• Kara Lynn Marie Langowski
• Larry C. Larsen, R.PH.
• John Larson
• Legendary Smiles Dental Group
• Legendary Smiles, P.C.
• Lev3L Performance Physical Therapy

• Community/Retail Pharmacy in Watford City, ND
• Providers in Watford City, ND by specialty
• Community/Retail Pharmacy in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.