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General NPI Number Information
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NPI Number | 1083850051
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Entity Type | Organization
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Legal Business Name | REDLERS LONG TERM CARE PHARMACY
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 317 DAKOTA DUNES BLVD STE A
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5341
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Country | US
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Telephone | 605-235-1552
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Fax | 605-235-1554
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Provider Business Mailing Address
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Address Line | 317 DAKOTA DUNES BLVD STE A
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5341
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Country | US
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Telephone | 605-235-1552
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Fax | 605-235-1554
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Authorized Official
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Title or Position | OWNER
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Name | TROY REDLER
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Credential |
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Telephone | 605-235-1552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 1001949
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 577
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 3691
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License Number State | IA
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