Organization Active NPI

Ellendale Pharmacy Inc

  • Community/Retail Pharmacy
  • Ellendale, ND
National Provider Identifier
1831559921
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHAR535 Issued in ND
Legal business name
ELLENDALE PHARMACY INC
Practice address
117 Main St
Ellendale, ND 58436-7101
Phone
(701) 349-3390
Fax
(701) 349-3052
NPI assigned
Mar 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Authorized official

Name
Jeffrey UlmerNPI 1285093708
Title
Owner/Pic
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHAR535 ND Primary

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 1

IdentifierTypeStateIssuer
2158114OtherPK

Other names 1

  • Ellendale Pharmacy Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160630001490 ND DME Supplier - Pharmacy 8921390592 Practice locations: Ellendale, ND
O20231027002656 ND Part B Supplier - Mass Immunization (Roster Biller Only) 8921390592 Practice locations: Ellendale, ND

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": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1831559921",
    "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": "800-324-8084"
        },
        {
            "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": "ELLENDALE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "ULMER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "701-349-3390"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ND",
            "license": "PHAR535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158114",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellendale Pharmacy Inc",
            "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 6, 2026; 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.