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General NPI Number Information
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NPI Number | 1598769531
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Entity Type | Organization
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Legal Business Name | LIEBE DRUG, INC.
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 109 S MAIN ST
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City | MILBANK
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State | SD
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Zip | 57252-1806
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Country | US
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Telephone | 605-432-5541
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Fax | 605-432-6258
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Provider Business Mailing Address
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Address Line | 109 S MAIN ST
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City | MILBANK
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State | SD
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Zip | 57252-1806
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Country | US
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Telephone | 605-432-5541
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Fax | 605-432-6258
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. PAUL A SINCLAIR
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Credential | RPH
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Telephone | 605-432-5541
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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 | 100-0487
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License Number State | SD
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