Provider Demographics
NPI:1932824083
Name:REMINGTON, KEVIN KEITH JR (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:KEITH
Last Name:REMINGTON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 43RD AVE NE APT 118
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-8088
Mailing Address - Country:US
Mailing Address - Phone:701-255-1335
Mailing Address - Fax:
Practice Address - Street 1:525 S 3RD ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5524
Practice Address - Country:US
Practice Address - Phone:701-255-1335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist