Lifescript Pharmacy PLLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR567 Issued in ND

Legal business name

LIFESCRIPT PHARMACY PLLC

Practice address

5670 38TH Ave S Unit a
Fargo, ND 58104-9051

Phone

(701) 205-4545

Fax

(701) 205-0305

NPI assigned

Sep 23, 2017

Organization subpart

No

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

Authorized official

Name

Simonne Coimbra Fonseca, RPH

Title

Owner

Phone

(832) 549-3935

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Scott Barglof

  • Pharmacist
  • Fargo, ND
  • NPI 1457674376
  NPD

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

{
    "created_epoch": "1506124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1912416876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 38TH AVE S UNIT A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581049051",
            "telephone_number": "701-205-4545",
            "fax_number": "701-205-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 38TH AVE S UNIT A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581049051",
            "telephone_number": "701-205-4545",
            "fax_number": "701-205-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESCRIPT PHARMACY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-23",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "FONSECA",
        "authorized_official_first_name": "SIMONNE",
        "authorized_official_middle_name": "COIMBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-549-3935",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ND",
            "license": "PHAR567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1474535",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Light House Recovery Services
• Lighthouse Church of Fargo
• Mitchell Julius Likness, PA-C

• Community/Retail Pharmacy in Fargo, ND
• Providers in Fargo, ND by specialty
• Community/Retail Pharmacy in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.