Healthcare Provider Details

I. General information

NPI: 1639108749
Provider Name (Legal Business Name): COMMUNITY PHARMACIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 EAST DAKOTA AVE SUITE #2
PIERRE SD
57501-1215
US

IV. Provider business mailing address

PO BOX 1215 ATTN: DME MANAGER
PIERRE SD
57501-1215
US

V. Phone/Fax

Practice location:
  • Phone: 605-224-4538
  • Fax: 605-224-8027
Mailing address:
  • Phone: 605-224-4538
  • Fax: 605-224-8027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number100-0981
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JAMES R. STEPHENS
Title or Position: PRESIDENT
Credential:
Phone: 605-224-4538