Healthcare Provider Details

I. General information

NPI: 1548192693
Provider Name (Legal Business Name): KH PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 2ND AVE NW
MANDAN ND
58554-3122
US

IV. Provider business mailing address

116 2ND AVE NW
MANDAN ND
58554-3122
US

V. Phone/Fax

Practice location:
  • Phone: 701-663-1151
  • Fax: 701-663-4514
Mailing address:
  • Phone: 701-663-1151
  • Fax: 701-663-4514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KENNETH HAUGEN
Title or Position: PRESIDENT/PHARMD
Credential:
Phone: 701-663-1151