Healthcare Provider Details

I. General information

NPI: 1255250262
Provider Name (Legal Business Name): AUSTIN MANUELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S CLIFF AVE
SIOUX FALLS SD
57105-1005
US

IV. Provider business mailing address

4011 W 54TH ST N APT 2301
SIOUX FALLS SD
57107-2149
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-8042
  • Fax:
Mailing address:
  • Phone: 507-254-2053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number7249
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: