Healthcare Provider Details

I. General information

NPI: 1396846283
Provider Name (Legal Business Name): SHEILA K HOFFMAN R PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 8TH AVE S
FAULKTON SD
57438-2115
US

IV. Provider business mailing address

PO BOX 70
FAULKTON SD
57438-0070
US

V. Phone/Fax

Practice location:
  • Phone: 605-598-4187
  • Fax:
Mailing address:
  • Phone: 605-598-4187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3963
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: