Organization Name: | NORTHMED COMPOUNDING PHARMACY |
NPI Number: | 1124143532 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KASSI KRAFT (DME MANAGER, PHARMACY TECHNICIAN) |
Mailing Address: | 1202 W Chisholm St Unit-a Alpena |
State: | MI US |
Postal Code: | 497071620 |
Phone Number: | 9893543189 |
Fax Number: | 9893543286 |
NPI Enumeration Date: | 03/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0004X |
License Number: | 5301008061 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Compounding Pharmacy |
Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |