| NPI | 1215781000 |
|---|---|
| Doing Business As | SOUTH STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | CORINDA LEE GEILE Owner/PIC 307-331-2784 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2024-04-16 |