Provider Demographics
NPI:1215371695
Name:ECONOMY DRUG MOTT INC
Entity Type:Organization
Organization Name:ECONOMY DRUG MOTT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:OIEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:701-824-2897
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:216 BROWN AVE
Mailing Address - City:MOTT
Mailing Address - State:ND
Mailing Address - Zip Code:58646-0279
Mailing Address - Country:US
Mailing Address - Phone:701-824-2897
Mailing Address - Fax:701-824-4321
Practice Address - Street 1:216 BROWN AVE
Practice Address - Street 2:
Practice Address - City:MOTT
Practice Address - State:ND
Practice Address - Zip Code:58646-0279
Practice Address - Country:US
Practice Address - Phone:701-824-2897
Practice Address - Fax:701-824-4321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPHAR5523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy