Provider Demographics
NPI:1336477223
Name:CHAMBERZ, LLC
Entity Type:Organization
Organization Name:CHAMBERZ, LLC
Other - Org Name:SERVICE DRUG & GIFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ZIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-324-2227
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:ND
Mailing Address - Zip Code:58341-0325
Mailing Address - Country:US
Mailing Address - Phone:701-324-2227
Mailing Address - Fax:701-324-4754
Practice Address - Street 1:815 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:ND
Practice Address - Zip Code:58341
Practice Address - Country:US
Practice Address - Phone:701-324-2227
Practice Address - Fax:701-324-4754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1456830Medicaid