Organization

Southtown Econodrug, Inc.

Community/Retail Pharmacy in Wahpeton, ND(View on Map)

Legal Business Name

Southtown Econodrug, Inc.

NPI Number

1710977897

NPI Type

Organization

Enumeration Date

10/28/2005

Specialties

(Taxonomies)

Code

3336C0003X

Primary Taxonomy

Yes

Licenses

State

North Dakota

License Number

152

Contact
Information

Purpose

Mailing
Location

Address

387 11TH ST S
387 11TH ST S

City

Wahpeton
Wahpeton

State

ND
ND

Postal Code

58075-4653
58075-4653

Country

US
US

Telephone Number

(701) 642-2336
(701) 642-2336

Authorized Official

Name

Paula Mcdonald

Title or Position

PRESIDENT

Telephone Number

(701) 642-2336

Identifiers

Identifier

21128
9167120
091062700
0776850001

Identifier State

ND
SD
MN
ND

Identifier Issuer

Unknown
Unknown
Unknown
MEDICARE PART B NSC#

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/06/2012

Provider Address

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Organization

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Organization

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Organization

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