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Organization
KIRK WILSON MARTIN DRUG & MERCANTILE
Active
Organization
KIRK WILSON MARTIN DRUG & MERCANTILE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIRK STEPHEN WILSON RPH (PHARMACIST)
(605) 685-6200
Entity
Organization
Contact information
Practice address
304 MAIN ST, MARTIN, SD 57551-0050
(605) 685-6200
(605) 685-6366
Mailing address
304 MAIN ST, BOX A, MARTIN, SD 57551-0050
(605) 685-6200
(605) 685-6366
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
100-0514
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8500280
—
SD
Enumeration date
10/26/2006
Last updated
06/17/2008
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