Organization Active NPI

Heritage Pharmacy East Inc

  • Community/Retail Pharmacy
  • Bismarck, ND
National Provider Identifier
1770029613
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
995 Issued in ND
Legal business name
HERITAGE PHARMACY EAST INC
Practice address
401 N 9TH St
Bismarck, ND 58501-4530
Phone
(701) 751-6200
Fax
(701) 751-2713
NPI assigned
Jan 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Andrew Kristensen
Title
Pharmacist
Phone
(701) 751-6200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 995 ND Primary

Addresses

Primary practice location

401 N 9TH St
Bismarck, ND 58501-4530

Mailing address

401 N 9TH St
Bismarck, ND 58501-4530
Phone (701) 751-6200

Other identifiers 2

IdentifierTypeStateIssuer
1469864MedicaidND
2166898OtherPK

Other names 1

  • Heritage Pharmacy Main Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201102001301 ND Part B Supplier - Mass Immunization (Roster Biller Only) 7113133935 Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Locations

1000 E Rosser Ave
Bismarck, ND 58501
Phone (701) 530-6000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1770029613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014530",
            "telephone_number": "701-751-6200",
            "fax_number": "701-751-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014530",
            "telephone_number": "701-751-6200",
            "fax_number": "701-751-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PHARMACY EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2025-05-01",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "KRISTENSEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "701-751-6200"
    },
    "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": "995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469864",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2166898",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Pharmacy Main",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.