NPIMap

Organization Active NPI

Trenton Indian Service Area

  • Clinic Pharmacy
  • Trenton, ND
National Provider Identifier
1730307125
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
TRENTON INDIAN SERVICE AREA
Practice address
331 4TH Ave E
Trenton, ND 58853-9998
Phone
(701) 774-0461
Fax
(701) 774-8003
NPI assigned
Apr 23, 2007
Last updated
Oct 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Authorized official

Name
Mr. Eugene H Ladue
Title
Chairperson
Phone
(701) 774-8316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

331 4TH Ave E
Trenton, ND 58853-9998

Mailing address

331 4TH Ave E
PO Box 210
Trenton, ND 58853-9998
Phone (701) 774-0461

Other identifiers 3

IdentifierTypeStateIssuer
287001OtherNDBCBS
1312MedicaidND
35D0409330OtherNDCLIA NO

National Provider Directory

National Provider Directory
Tax ID family
Trenton Indian Service6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446076800000",
    "number": "1730307125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 4TH AVE E",
            "address_2": "PO BOX 210",
            "city": "TRENTON",
            "state": "ND",
            "postal_code": "588539998",
            "telephone_number": "701-774-0461",
            "fax_number": "701-774-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 4TH AVE E",
            "city": "TRENTON",
            "state": "ND",
            "postal_code": "588539998",
            "telephone_number": "701-774-0461",
            "fax_number": "701-774-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENTON INDIAN SERVICE AREA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2015-10-29",
        "status": "A",
        "authorized_official_last_name": "LADUE",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHAIRPERSON",
        "authorized_official_telephone_number": "701-774-8316",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "287001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1312",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NO",
            "identifier": "35D0409330",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.