Provider Demographics
NPI:1164579249
Name:PHARMACISTS ASSOCIATES LLC
Entity Type:Organization
Organization Name:PHARMACISTS ASSOCIATES LLC
Other - Org Name:LARIMORE DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-256-3330
Mailing Address - Street 1:PO BOX 438
Mailing Address - Street 2:
Mailing Address - City:LARIMORE
Mailing Address - State:ND
Mailing Address - Zip Code:58251-0438
Mailing Address - Country:US
Mailing Address - Phone:701-343-2461
Mailing Address - Fax:701-343-2305
Practice Address - Street 1:203 TOWNER AVE
Practice Address - Street 2:
Practice Address - City:LARIMORE
Practice Address - State:ND
Practice Address - Zip Code:58251-4311
Practice Address - Country:US
Practice Address - Phone:701-343-2461
Practice Address - Fax:701-343-2305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND20689Medicaid
ND0766740001Medicare NSC