Provider Demographics
NPI:1801807318
Name:BELGRADE DRUG AND HARDWARE INC
Entity type:Organization
Organization Name:BELGRADE DRUG AND HARDWARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-628-2036
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MN
Mailing Address - Zip Code:56312-0159
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:337 WASHBURN AVE
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MN
Practice Address - Zip Code:56312
Practice Address - Country:US
Practice Address - Phone:320-254-8286
Practice Address - Fax:320-254-8506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336M0002X, 3336L0003X, 333600000X
MN2616653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN722857100Medicaid
2403525OtherNCPDP PROVIDER IDENTIFICATION NUMBER
1290980001Medicare NSC