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NPI Code Detail

MEDICARE: LEWIS FAMILY DRUG, LLC

MEDICARE: LEWIS FAMILY DRUG, LLC
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
1333600000XPharmacy1001877SD
23336C0003XCommunity/Retail Pharmacy
33336C0002XClinic Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24353796OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1659392611
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEWIS FAMILY DRUG, LLC
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 : 605-367-2800
Fax Number :
Provider Business Practice Location Address
First Line : 7220 W 41ST ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-6038
Country : US
Telephone Number : 605-367-2010
Fax Number : 605-274-2142
Authorized Official
Title or Position : DIR OF CORP SVCS
Name : DAVID NIELSEN
Credential :
Telephone Number : 605-367-2824
Provider Enumeration Date : 07/22/2006
Last Update Date : 12/20/2007

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Directions to “LEWIS FAMILY DRUG, LLC ” Practice Location

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