=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578552899
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NELSON DRUG INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2005
-----------------------------------------------------
Last Update Date | 08/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 125 S MAIN ST
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-983-5711
-----------------------------------------------------
Fax | 605-983-5711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 384
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57212-0384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-983-5711
-----------------------------------------------------
Fax | 605-983-5711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST
-----------------------------------------------------
Name | JULIE E SEAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 605-983-5711
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 1000966
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------