Provider Demographics
NPI:1518001916
Name:RINGOLD DRUG STORES, INC.
Entity Type:Organization
Organization Name:RINGOLD DRUG STORES, INC.
Other - Org Name:HOWARD LAKE DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RINGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:320-543-2141
Mailing Address - Street 1:732 6TH ST
Mailing Address - Street 2:P.O. BOX 220
Mailing Address - City:HOWARD LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55349-5645
Mailing Address - Country:US
Mailing Address - Phone:320-543-2141
Mailing Address - Fax:320-543-3358
Practice Address - Street 1:732 6TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD LAKE
Practice Address - State:MN
Practice Address - Zip Code:55349-5645
Practice Address - Country:US
Practice Address - Phone:320-543-2141
Practice Address - Fax:320-543-3358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN291916-93336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0201440001Medicare ID - Type Unspecified