Healthcare Provider Details

I. General information

NPI: 1932583317
Provider Name (Legal Business Name): QUEENA GETSKOW PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W PARK AVE
VIBORG SD
57070-2048
US

IV. Provider business mailing address

PO BOX 496
VIBORG SD
57070-0496
US

V. Phone/Fax

Practice location:
  • Phone: 605-326-5211
  • Fax: 605-326-5341
Mailing address:
  • Phone: 605-326-5211
  • Fax: 605-326-5341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5133
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: