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General NPI Number Information
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NPI Number | 1427177617
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Entity Type | Organization
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Legal Business Name | DRAYTON DRUG INC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 NORTH MAIN ST
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City | DRAYTON
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State | ND
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Zip | 58225-0340
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Country | US
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Telephone | 701-454-3831
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Fax |
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Provider Business Mailing Address
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Address Line | 106 NORTH MAIN ST
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City | DRAYTON
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State | ND
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Zip | 58225-0340
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Country | US
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Telephone | 701-454-3831
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | KEITH KJELLAND
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Credential | RPH
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Telephone | 701-454-3831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 15136100
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License Number State | ND
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