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General NPI Number Information
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NPI Number | 1033437223
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Entity Type | Organization
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Legal Business Name | WULLSTEIN PHARMACY INC.
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 116 E HOLLY BLVD
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City | BRANDON
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State | SD
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Zip | 57005-1114
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Country | US
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Telephone | 605-582-6000
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Fax | 605-582-6200
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Provider Business Mailing Address
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Address Line | 116 E HOLLY BLVD
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City | BRANDON
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State | SD
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Zip | 57005-2658
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Country | US
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Telephone | 605-582-6000
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Fax | 605-582-6200
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Authorized Official
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Title or Position | OWNER
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Name | TOM WULLSTEIN
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Credential | PHARMD
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Telephone | 605-582-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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