Healthcare Provider Details

I. General information

NPI: 1578522371
Provider Name (Legal Business Name): BONNIE M KARY
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 7TH ST
EUREKA SD
57437
US

IV. Provider business mailing address

502 9TH ST PO BOX 457
EUREKA SD
57437-0457
US

V. Phone/Fax

Practice location:
  • Phone: 605-284-2752
  • Fax: 605-284-5142
Mailing address:
  • Phone: 605-284-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT-0257
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: