Healthcare Provider Details

I. General information

NPI: 1669468906
Provider Name (Legal Business Name): MILLER DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W 1ST ST STE 2
REDFIELD SD
57469-1503
US

IV. Provider business mailing address

PO BOX 878
PHILIP SD
57567-0878
US

V. Phone/Fax

Practice location:
  • Phone: 605-472-1810
  • Fax: 605-472-1812
Mailing address:
  • Phone: 605-472-1810
  • Fax: 605-472-1812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1000057
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number1000057
License Number StateSD

VIII. Authorized Official

Name: DILLON KJERSTAD
Title or Position: OWNER
Credential:
Phone: 605-859-2843