| NPI | 1457571457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ANN BEBENSEE Staff Pharmacist 605-582-8544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: SD 5141) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |