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MR. BRENT KERRY RODENHIZER R. PH.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1346339215

Individual Registrant:
MR. BRENT KERRY RODENHIZER R. PH.
Gender: M
Sole Proprietor

Location and contact information for practice:
107 S MAIN ST  STANLEY, ND 58784-0460 US
Tel: 701-628-2255  Fax: 701-628-2396

Contact information for business:
PO BOX 460  STANLEY, ND 58784-0460 US
Tel: 701-628-2255  Fax: 701-628-2396

Registration Information:
NPI: 1346339215
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
ND3905

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PHARMACIST LICENSE NUMBER8300AZ01
PHARMACIST LICENSE NUMBER3905ND01




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