Provider Demographics
NPI:1962706036
Name:INHEALTH SPECIALTY PHARMACY, INC.
Entity type:Organization
Organization Name:INHEALTH SPECIALTY PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEEDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-365-6050
Mailing Address - Street 1:2345 25TH ST S STE C
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6173
Mailing Address - Country:US
Mailing Address - Phone:701-365-6050
Mailing Address - Fax:
Practice Address - Street 1:2345 25TH ST S STE C
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6173
Practice Address - Country:US
Practice Address - Phone:701-365-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy