Provider Demographics
NPI:1801900881
Name:HANKINSON DRUG INC
Entity type:Organization
Organization Name:HANKINSON DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT, PIC
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FALK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:701-242-7414
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:HANKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58041-0160
Mailing Address - Country:US
Mailing Address - Phone:701-242-7414
Mailing Address - Fax:701-242-7173
Practice Address - Street 1:323 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:HANKINSON
Practice Address - State:ND
Practice Address - Zip Code:58041-4100
Practice Address - Country:US
Practice Address - Phone:701-242-7414
Practice Address - Fax:701-242-7173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 3336C0004X, 332B00000X, 3336M0003X, 333600000X
NDPHAR43336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8531510Medicaid
ND20075Medicaid
2070830OtherPK
MN8233187Medicaid
ND20075Medicaid