Healthcare Provider Details
I. General information
NPI: 1750741807
Provider Name (Legal Business Name): K REMEDY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2016
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2211 NW PROFESSIONAL DR SUITE 201
CORVALLIS OR
97330-3891
US
IV. Provider business mailing address
2211 NW PROFESSIONAL DR SUITE 201
CORVALLIS OR
97330-3891
US
V. Phone/Fax
- Phone: 185-572-2551
- Fax: 541-230-1189
- Phone: 185-572-2551
- Fax: 541-230-1189
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
ANDREW
MAY
Title or Position: COO/CMO
Credential: M.D
Phone: 541-740-2537