Provider Demographics
NPI:1326059981
Name:B & B DRUG INC
Entity Type:Organization
Organization Name:B & B DRUG INC
Other - Org Name:B & B NORTHWEST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHL
Authorized Official - Suffix:
Authorized Official - Credentials:B SC PHARMACY
Authorized Official - Phone:701-838-2213
Mailing Address - Street 1:20 BURDICK EXPY W
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-4498
Mailing Address - Country:US
Mailing Address - Phone:701-838-2213
Mailing Address - Fax:701-838-2227
Practice Address - Street 1:20 BURDICK EXPY W
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4498
Practice Address - Country:US
Practice Address - Phone:701-838-2213
Practice Address - Fax:701-838-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
ND1613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2070899OtherPK
ND20118Medicaid
2070899OtherPK