Healthcare Provider Details

I. General information

NPI: 1528093259
Provider Name (Legal Business Name): OAKES DRUG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 MAIN AVE
OAKES ND
58474-1637
US

IV. Provider business mailing address

422 MAIN AVE
OAKES ND
58474-1637
US

V. Phone/Fax

Practice location:
  • Phone: 701-742-2118
  • Fax: 701-742-3101
Mailing address:
  • Phone: 701-742-2118
  • Fax: 701-742-3101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number217
License Number StateND

VIII. Authorized Official

Name: MICHAEL A. SPIESE
Title or Position: PRESIDENT
Credential: R. PH.
Phone: 701-742-2118