MEDICARE: B&L INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	100-0980	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4301874	OTHER	SD	NCPDP #

General Provider Information

NPI Number	:	1417932799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B&L INC

Provider Business Mailing Address
First Line	:	PO BOX 9009
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57709-9009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 E SAINT PATRICK ST
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-5728
Country	:	US
Telephone Number	:	605-348-0741
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	SCOTT VINCENT
Credential	:
Telephone Number	:	605-343-4864

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	08/22/2020

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Directions to “B&L INC ” Practice Location

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