Ye Olde Medicine Shoppe

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR59 Issued in ND

Legal business name

YE OLDE MEDICINE SHOPPE

Doing business as

Ye Olde Medicine Center

Practice address

503 Park St W
Park River, ND 58270-4137

Phone

(701) 284-7676

Fax

(701) 284-6129

NPI assigned

Jun 11, 2006

Last updated

Sep 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurie Larson, RPH

Title

Presdient

Phone

(701) 284-7676

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• YE OLDE MEDICINE CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in ND2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Ye Olde Medicine Shoppe Inc

  dba Drayton Drug

  • Community/Retail Pharmacy
  • Drayton, ND
  • NPI 1790004182

  3072630235

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Ye Olde Medicine Shoppe Inc

  dba Drayton Drug

  • Community/Retail Pharmacy
  • Drayton, ND
  • NPI 1790004182

  O20130123000480

  Same enrollment

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

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1720020324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 PARK ST W",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "582704137",
            "telephone_number": "701-284-7676",
            "fax_number": "701-284-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 PARK ST W",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "582704137",
            "telephone_number": "701-284-7676",
            "fax_number": "701-284-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YE OLDE MEDICINE SHOPPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "PRESDIENT",
        "authorized_official_telephone_number": "701-284-7676",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ND",
            "license": "PHAR59",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2071194",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20668",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YE OLDE MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Park River)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Park River)
• Villa Nazareth (Friendship, Inc.)
• Villa Nazareth (Friendship Inc)
• Walsh County Senior Citizens Council (Walsh County Transportation)

• Community/Retail Pharmacy in Park River, ND
• Providers in Park River, 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 Sep 19, 2025; 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.