Active NPI
Clinic Pharmacy Inc
Doing business as Clinic Pharmacy LTC
- Long Term Care Pharmacy
- Dickinson, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- CLINIC PHARMACY INC
- Doing business as
- Clinic Pharmacy LTC
- Practice address
- 2615 Fairway St
Dickinson, ND 58601-2590 - Phone
- (701) 483-4401
- Fax
- (701) 483-4404
- NPI assigned
- Jan 29, 2024
- Last updated
- Feb 14, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brandi Lee Ollerman
- Title
- Pharmd, Owner
- Phone
- (701) 227-8265
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
2615 Fairway St
Dickinson, ND 58601-2590
Mailing address
2615 Fairway St
Dickinson, ND 58601-2590
Phone (701) 483-4401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1454568 | Medicaid | ND |
Other names 1
- Clinic Pharmacy LTC
National Provider Directory
National Provider Directory- Tax ID family
- Clinic Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
2615 Fairway St
Dickinson, ND 58601
Phone (701) 456-6000
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Dickinson, ND
- NPI 1932134426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706486400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707868800000",
"number": "1770345225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 FAIRWAY ST",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586012590",
"telephone_number": "701-483-4401",
"fax_number": "701-483-4404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 FAIRWAY ST",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586012590",
"telephone_number": "701-483-4401",
"fax_number": "701-483-4404"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLINIC PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-01-29",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A",
"authorized_official_last_name": "OLLERMAN",
"authorized_official_first_name": "BRANDI",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "PHARMD, OWNER",
"authorized_official_telephone_number": "701-227-8265",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1454568",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Clinic Pharmacy LTC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dickinson, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.