Provider Demographics
NPI:1619027810
Name:DRS KREIN AND MOEN, PC
Entity Type:Organization
Organization Name:DRS KREIN AND MOEN, PC
Other - Org Name:RUGBY EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V PRES. AND SECT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KREIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:701-776-6538
Mailing Address - Street 1:126 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:RUGBY
Mailing Address - State:ND
Mailing Address - Zip Code:58368-1700
Mailing Address - Country:US
Mailing Address - Phone:701-776-6538
Mailing Address - Fax:701-776-6538
Practice Address - Street 1:126 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:RUGBY
Practice Address - State:ND
Practice Address - Zip Code:58368-1700
Practice Address - Country:US
Practice Address - Phone:701-776-6538
Practice Address - Fax:701-776-6538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR526152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND23499OtherBCBS
ND0311120003OtherCIGNA MEDICARE
ND60407Medicaid
ND892820OtherVSI
ND410023897OtherRAILROAD MEDICARE
ND1861475709OtherBRATVOLD NPI#
ND1124124623OtherMOEN
ND60456Medicaid
ND0311120003OtherCIGNA MEDICARE
NDN23499Medicare ID - Type UnspecifiedDR. NUMBER
ND60407Medicaid
ND892820OtherVSI