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Export Provider Record NPI 1215063409
Medical Pharmacy Moorhead Inc
Organization Subpart: NO
Active
NPI Number1215063409
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1215063409
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2007-02-24
Last Updated2017-02-20
Authorized OfficialSheila Nudell
PRESIDENT AND MANAGER
Phone: 2182337365
Mailing Address101 11th St S
Moorhead, MN 56560-2899
United States
Phone: (218) 233-7365 | Fax: (218) 233-5702
📍 View Map
Primary Practice Address101 11th St S
Moorhead, MN 56560-2899
United States
Phone: (218) 233-7365 | Fax: (218) 233-5702
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDND021062-
MEDICAIDMN066360300-
Other (non-Medicare)-2046710PK
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies--
No3336L0003X – Pharmacy, Long Term Care Pharmacy--
No3336C0004X – Pharmacy, Compounding Pharmacy--
No333600000X – Pharmacy--
Yes3336C0003X – Pharmacy, Community/Retail PharmacyMN260722
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About NPI 1215063409

Medical Pharmacy Moorhead Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1215063409. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Moorhead, MN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-02-24. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1215063409?

NPI 1215063409 belongs to Medical Pharmacy Moorhead Inc, a Pharmacy, Community/Retail Pharmacy in Moorhead, MN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1215063409 active?

The current status of NPI 1215063409 in the NPPES registry is Active. The record was last updated on 2017-02-20.

What specialty is NPI 1215063409?

NPI 1215063409 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1215063409?

You can verify NPI 1215063409 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1215063409?

The primary practice address on file for NPI 1215063409 is 101 11th St S, Moorhead, MN 56560-2899. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1215063409 issued?

NPI 1215063409 was first issued (enumerated) on 2007-02-24. The NPPES record was last updated on 2017-02-20.

Practice Location Map

Medical Pharmacy Moorhead Inc is located at 101 11th St S, Moorhead, MN. Use the map below to find directions or verify the practice location.

📍 101 11th St S, Moorhead, MN 56560-2899  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Medical Pharmacy Moorhead Inc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1215063409. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy260722MN
Data Verified from CMS NPPES Last synced: 2026-07-17 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162