Provider Demographics
NPI:1528093259
Name:OAKES DRUG, INC.
Entity type:Organization
Organization Name:OAKES DRUG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPIESE
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:701-742-2118
Mailing Address - Street 1:422 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKES
Mailing Address - State:ND
Mailing Address - Zip Code:58474-1637
Mailing Address - Country:US
Mailing Address - Phone:701-742-2118
Mailing Address - Fax:701-742-3101
Practice Address - Street 1:422 MAIN AVE
Practice Address - Street 2:
Practice Address - City:OAKES
Practice Address - State:ND
Practice Address - Zip Code:58474-1637
Practice Address - Country:US
Practice Address - Phone:701-742-2118
Practice Address - Fax:701-742-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1256260001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER