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Contact Information

EDGELEY PHARMACY LLC
503 MAIN ST
STE B
EDGELEY, ND58433-7119
 Phone: 701-493-2810
 Fax: 701-493-2263
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for EDGELEY PHARMACY LLC

NPI Number 1548566698
LBN Legal business name EDGELEY PHARMACY LLC
Authorized official DANIEL CHURCHILL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/08/2011
Last updated 08/27/2025 - About 9 months ago
Identifiers
ND License # 717
ND Medicaid 1464337
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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