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General NPI Number Information
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NPI Number | 1851328751
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Entity Type | Organization
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Legal Business Name | REILLY PHARMACY LLC
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 720 E. FIRST STREET
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City | TEA
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State | SD
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Zip | 57064-0487
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Country | US
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Telephone | 605-368-5333
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Fax | 605-368-5337
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Provider Business Mailing Address
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Address Line | PO BOX 487
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City | TEA
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State | SD
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Zip | 57064-0487
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Country | US
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Telephone | 605-368-5333
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Fax | 605-368-5337
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Authorized Official
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Title or Position | OWNER
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Name | VINCENT GERARD REILLY
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Credential | RPH
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Telephone | 605-368-5333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 100-1869
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License Number State | SD
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