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General NPI Number Information
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NPI Number | 1265448906
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Entity Type | Organization
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Legal Business Name | WOLLMANS OF VERMILLION
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 11 W CHERRY ST
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City | VERMILLION
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State | SD
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Zip | 57069-1107
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Country | US
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Telephone | 605-624-8038
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Fax | 605-624-8039
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Provider Business Mailing Address
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Address Line | PO BOX 120
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City | FREEMAN
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State | SD
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Zip | 57029-0120
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NORM KAUFMAN
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Credential | RPH
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Telephone | 605-624-8038
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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 | 1000513
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License Number State | SD
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