Provider Demographics
NPI:1891202354
Name:DLG PHARMACY, LLC
Entity Type:Organization
Organization Name:DLG PHARMACY, LLC
Other - Org Name:OAKES FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:701-742-2118
Mailing Address - Street 1:422 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKES
Mailing Address - State:ND
Mailing Address - Zip Code:58474-1637
Mailing Address - Country:US
Mailing Address - Phone:701-742-2118
Mailing Address - Fax:701-742-3101
Practice Address - Street 1:422 MAIN AVE
Practice Address - Street 2:
Practice Address - City:OAKES
Practice Address - State:ND
Practice Address - Zip Code:58474-1637
Practice Address - Country:US
Practice Address - Phone:701-742-2118
Practice Address - Fax:701-742-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy