MEDICARE: LEWIS DRUGS INC

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy
2	3336C0004X	Compounding Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	333600000X	Pharmacy	1001919	SD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2094342	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1295825297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEWIS DRUGS INC

Provider Business Mailing Address
First Line	:	2701 S MINNESOTA AVE
Second Line	:	SUITE 1
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-4744
Country	:	US
Telephone Number	:	605-367-2850
Fax Number	:	605-367-2876

Provider Business Practice Location Address
First Line	:	6109 S LOUISE AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-5981
Country	:	US
Telephone Number	:	605-367-2510
Fax Number	:	605-367-2519

Authorized Official
Title or Position	:	EVP/CFO/AO
Name	:	SCOTT CROSS
Credential	:
Telephone Number	:	605-367-2800

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	02/23/2017

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

6101 S LOUISE AVE
SIOUX FALLS, SD
57108-5981