| NPI | 1154464212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN FOKKEN Owner 605-692-7992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: SD 1001922) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-09-12 |