Healthcare Provider Details

I. General information

NPI: 1619185626
Provider Name (Legal Business Name): GREGORY DRUG, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 MAIN ST
GREGORY SD
57533-1349
US

IV. Provider business mailing address

604 MAIN ST
GREGORY SD
57533-1349
US

V. Phone/Fax

Practice location:
  • Phone: 605-835-8198
  • Fax: 605-835-8827
Mailing address:
  • Phone: 605-835-8198
  • Fax: 605-835-8827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1000505
License Number StateSD

VIII. Authorized Official

Name: DANIEL FIEBELKORN
Title or Position: OWNER
Credential:
Phone: 605-835-8198