MEDICARE: MRS. BRANDY LEE LUDEMANN PHARM D

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	183500000X	Pharmacist	5278	SD

General Provider Information

NPI Number	:	1750368098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRANDY LEE LUDEMANN PHARM D

Provider Business Mailing Address
First Line	:	213 E HUSTAN AVE STE A
Second Line	:
City	:	FORT PIERRE
State	:	SD
Zip	:	57532-5103
Country	:	US
Telephone Number	:	605-223-9200
Fax Number	:	605-223-9201

Provider Business Practice Location Address
First Line	:	213 E HUSTAN AVE STE A
Second Line	:
City	:	FORT PIERRE
State	:	SD
Zip	:	57532-5103
Country	:	US
Telephone Number	:	605-223-9200
Fax Number	:	605-223-9201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	06/01/2022

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