Provider Demographics
NPI:1053879734
Name:MPND,INC
Entity type:Organization
Organization Name:MPND,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NUDELL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:701-866-4779
Mailing Address - Street 1:2050 SHEYENNE ST
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-2797
Mailing Address - Country:US
Mailing Address - Phone:701-630-0695
Mailing Address - Fax:701-638-2006
Practice Address - Street 1:2050 SHEYENNE STREET
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078
Practice Address - Country:US
Practice Address - Phone:701-866-4779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy