Healthcare Provider Details

I. General information

NPI: 1356477442
Provider Name (Legal Business Name): DAKOTA COUNTRY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S CENTER
PHILIP SD
57567-0640
US

IV. Provider business mailing address

PO BOX 878
PHILIP SD
57567-0878
US

V. Phone/Fax

Practice location:
  • Phone: 605-859-2833
  • Fax: 605-859-3026
Mailing address:
  • Phone: 605-859-2833
  • Fax: 605-859-3026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1001993
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DILLON KJERSTAD
Title or Position: VICE PRESIDENT
Credential:
Phone: 605-270-7609