Provider Demographics
NPI:1285093708
Name:ULMER, JEFFREY (PHARM D)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:ULMER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELLENDALE
Mailing Address - State:ND
Mailing Address - Zip Code:58436-7101
Mailing Address - Country:US
Mailing Address - Phone:701-349-3390
Mailing Address - Fax:701-349-3052
Practice Address - Street 1:117 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLENDALE
Practice Address - State:ND
Practice Address - Zip Code:58436-7101
Practice Address - Country:US
Practice Address - Phone:701-349-3390
Practice Address - Fax:701-349-3052
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH5318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDRPH5318OtherNORTH DAKOTA STATE BOARD OF PHARMACY