Healthcare Provider Details

I. General information

NPI: 1740538230
Provider Name (Legal Business Name): SOUTH DAKOTA HUMAN SERVICES CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 BROADWAY AVE
YANKTON SD
57078-4917
US

IV. Provider business mailing address

3515 BROADWAY AVE
YANKTON SD
57078-4917
US

V. Phone/Fax

Practice location:
  • Phone: 605-668-3182
  • Fax: 605-668-3156
Mailing address:
  • Phone: 605-668-3182
  • Fax: 605-668-3156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number10577
License Number StateSD

VIII. Authorized Official

Name: MR. RIC COMPTON
Title or Position: CEO
Credential:
Phone: 605-668-3100