Healthcare Provider Details

I. General information

NPI: 1699688978
Provider Name (Legal Business Name): ALICIA MARTIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W 18TH ST
SIOUX FALLS SD
57105-0401
US

IV. Provider business mailing address

1501 S SCARLET OAK PL
SIOUX FALLS SD
57110-7712
US

V. Phone/Fax

Practice location:
  • Phone: 605-333-4233
  • Fax: 605-333-1572
Mailing address:
  • Phone: 605-212-9439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6324
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: