NPIMap

Organization Active NPI

North Dakota State University

  • Clinic Pharmacy
  • Fargo, ND
National Provider Identifier
1811939416
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PHAR168 Issued in ND
Legal business name
NORTH DAKOTA STATE UNIVERSITY
Practice address
1707 Centennial Blvd
Fargo, ND 58102
Phone
(701) 231-7332
Fax
(701) 231-6132
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Authorized official

Name
Alicia Fitz, PHARM DNPI 1134384100
Title
Pharmacist in Charge
Phone
(701) 231-7332

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)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PHAR168 ND Primary

Addresses

Primary practice location

1707 Centennial Blvd
Fargo, ND 58102

Mailing address

Ndsu Department 5150
PO Box 6050
Fargo, ND 58108-6050
Phone (701) 231-7332

Other identifiers 2

IdentifierTypeStateIssuer
21162NDMedicaidND
2070818OtherPK

Other names 1

  • NDSU Student Health Service Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Dakota State University5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1811939416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NDSU DEPARTMENT 5150",
            "address_2": "PO BOX 6050",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086050",
            "telephone_number": "701-231-7332",
            "fax_number": "701-231-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 CENTENNIAL BLVD",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58102",
            "telephone_number": "701-231-7332",
            "fax_number": "701-231-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DAKOTA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "FITZ",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "701-231-7332",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "ND",
            "license": "PHAR168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21162ND",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2070818",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NDSU Student Health Service Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.