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General NPI Number Information
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NPI Number | 1982626099
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Entity Type | Organization
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Legal Business Name | MED, INC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1508 2ND AVE W
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City | WILLISTON
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State | ND
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Zip | 58801-0000
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Country | US
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Telephone | 701-572-5884
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Fax | 701-572-1060
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Provider Business Mailing Address
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Address Line | 1508 2ND AVE W
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City | WILLISTON
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State | ND
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Zip | 58801
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Country | US
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Telephone | 701-572-5884
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Fax | 701-572-1060
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Authorized Official
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Title or Position | OWNER
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Name | DUANE K KRAM
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Credential | RPH
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Telephone | 701-572-5884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 38
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License Number State | ND
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