1477634475 NPI number — MRS. VALERIE KAY KUNZE PHARM.D., RPH

Table of content: MRS. VALERIE KAY KUNZE PHARM.D., RPH (NPI 1477634475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477634475 NPI number — MRS. VALERIE KAY KUNZE PHARM.D., RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUNZE
Provider First Name:
VALERIE
Provider Middle Name:
KAY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D., RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477634475
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
409 3RD AVE. NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOWMAN
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58623-0828
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-523-5567
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 6TH AVE. SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOWMAN
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-523-5267
Provider Business Practice Location Address Fax Number:
701-523-7104
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  4531 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4531 . This is a "ND STATE PHARMACY LICENSE" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com