1619027810 NPI number — DRS KREIN AND MOEN, PC

Table of content: (NPI 1619027810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619027810 NPI number — DRS KREIN AND MOEN, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS KREIN AND MOEN, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1619027810
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
126 2ND AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUGBY
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58368-1700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-776-6538
Provider Business Mailing Address Fax Number:
701-776-6538

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
126 2ND AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUGBY
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58368-1700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-776-6538
Provider Business Practice Location Address Fax Number:
701-776-6538
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KREIN
Authorized Official First Name:
KYLE
Authorized Official Middle Name:
D
Authorized Official Title or Position:
V PRES. AND SECT
Authorized Official Telephone Number:
701-776-6538

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  526 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 23499 . This is a "BCBS" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 0311120003 . This is a "CIGNA MEDICARE" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 60407 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 892820 . This is a "VSI" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 410023897 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 1861475709 . This is a "BRATVOLD NPI#" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 1124124623 . This is a "MOEN" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 60456 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com