Healthcare Provider Details

I. General information

NPI: 1053456558
Provider Name (Legal Business Name): SANFORD VERMILLION HOSPITAL PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 S PLUM ST
VERMILLION SD
57069-3346
US

IV. Provider business mailing address

20 S PLUM ST
VERMILLION SD
57069-3346
US

V. Phone/Fax

Practice location:
  • Phone: 605-638-8455
  • Fax: 605-624-8535
Mailing address:
  • Phone: 605-677-3660
  • Fax: 605-677-3661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN TUTTLE
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 605-328-8383