Lisbon Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Lisbon, ND

NPI 1720150238 · NPPES record last updated Jul 21, 2010

Key facts

NPI
1720150238
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
308 (ND)
Legal business name
LISBON PHARMACY INC
Practice address
404 Main St
Lisbon, ND 58054-4142
Phone
(701) 683-4691
Fax
(701) 683-4550
NPI assigned
Nov 14, 2006
Organization subpart
No

Authorized official

Name
Dennis Buchholz
Title
Pres
Phone
(701) 683-4691

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 308 ND Yes
Long Term Care Pharmacy 3336L0003X
Mail Order Pharmacy 3336M0002X

Addresses

Primary practice location

404 Main St
Lisbon, ND 58054-4142

Mailing address

PO Box 113
Lisbon, ND 58054-0113
Phone (701) 683-4691

Other identifiers

IdentifierTypeStateIssuer
3502970OtherNCPDP PROVIDER IDENTIFICATION NUMBER
020104MedicaidND

Other names

  • LISBON SHEYENNE PHARMACY Doing business as

Other providers in Lisbon, ND

All providers in Lisbon, ND · Community/Retail Pharmacy in North Dakota

Sources for this page

Verify at the official NPI Registry.