Healthcare Provider Details

I. General information

NPI: 1518083138
Provider Name (Legal Business Name): ACCUPAX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W. HIGHWAY 38 SUITE 106
HARTFORD SD
57033-0397
US

IV. Provider business mailing address

1385 HELENE DR
BROOKFIELD WI
53045-5405
US

V. Phone/Fax

Practice location:
  • Phone: 605-528-2001
  • Fax: 605-528-2003
Mailing address:
  • Phone: 312-287-7345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number100-1842
License Number StateSD

VIII. Authorized Official

Name: RON KUTRIEB
Title or Position: PRESIDENT
Credential:
Phone: 312-287-7345