Provider Demographics
NPI:1366845208
Name:DEGREE, MATTHEW CRAIG (RPH)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CRAIG
Last Name:DEGREE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:BOWMAN
Mailing Address - State:ND
Mailing Address - Zip Code:58623-1198
Mailing Address - Country:US
Mailing Address - Phone:701-527-8222
Mailing Address - Fax:
Practice Address - Street 1:12 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BOWMAN
Practice Address - State:ND
Practice Address - Zip Code:58623-4022
Practice Address - Country:US
Practice Address - Phone:701-523-3233
Practice Address - Fax:701-523-5294
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH5481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist