Organization
NORTHMED COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASSI KRAFT CPHT, CF (DME MANAGER, PHARMACY TECHNICIAN)
(989) 354-3189
Entity
Organization
Contact information
Practice address
1202 W CHISHOLM ST, UNIT-A, ALPENA, MI 49707-1620
(989) 354-3189
(989) 354-3286
Mailing address
1202 W CHISHOLM ST, UNIT-A, ALPENA, MI 49707-1620
(989) 354-3189
(989) 354-3286
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5301008061
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2366753
NCPDP#
—
01
—
5301008061
PHARMACY LICENSE
MI
Enumeration date
03/21/2007
Last updated
03/07/2023
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