NPIMap

Organization Active NPI

Thomas Ulmer

Doing business as Ellendale Pharmacy

  • Community/Retail Pharmacy
  • Ellendale, ND
National Provider Identifier
1811031511
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHAR17 Issued in ND
Legal business name
THOMAS ULMER
Doing business as
Ellendale Pharmacy
Practice address
117 Main St
Ellendale, ND 58436-7101
Phone
(701) 349-3390
Fax
(701) 349-3052
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Thomas UlmerNPI 1447273099
Title
Owner
Phone
(701) 349-3390

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHAR17 ND Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

117 Main St
Ellendale, ND 58436-7101

Mailing address

PO Box 780
Ellendale, ND 58436-0780
Phone (701) 349-3390

Other identifiers 2

IdentifierTypeStateIssuer
2070813OtherPK
20043MedicaidND

Other names 1

  • ELLENDALE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1811031511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "ELLENDALE",
            "state": "ND",
            "postal_code": "584360780",
            "telephone_number": "701-349-3390",
            "fax_number": "701-349-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MAIN ST",
            "city": "ELLENDALE",
            "state": "ND",
            "postal_code": "584367101",
            "telephone_number": "701-349-3390",
            "fax_number": "701-349-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS ULMER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "ULMER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-349-3390"
    },
    "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": "PHAR17",
            "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": "2070813",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20043",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELLENDALE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellendale, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.