| NPI | 1407141344 |
|---|---|
| Doing Business As | AVERA DERMATOLOGY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RONALD JOSEPH PLACE President/CEO 605-322-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 4651) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MN 265029) |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: SD 100-1965) | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2023-10-04 |