# FAMILY PHARMACY OF MOBRIDGE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY PHARMACY-CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407959539
- **Authorized official:** LEVI JENSEN (PRESIDENT)
- **Authorized official phone:** (605) 845-8140

## Contact information

- **Practice address:** 1317 10TH AVE W, MOBRIDGE, SD 57601-1146
- **Practice address phone:** (605) 845-8140
- **Practice address fax:** (605) 845-8146
- **Mailing address:** 1317 10TH AVE W, BOX 759, MOBRIDGE, SD 57601-1146
- **Mailing address phone:** (605) 845-8140
- **Mailing address fax:** (605) 845-8146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 1001797 | SD | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 02/28/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 020988 | — | ND |
| 01 | — | 2093771 | PK | — |
| 05 | — | 8501062 | — | SD |