# LEWIS FAMILY DRUG, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lewis Family Drug \#68
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417966029
- **Authorized official:** DAVE NIELSEN (DIRECTOR OF CORPORATE SERVICES)
- **Authorized official phone:** (605) 367-2800

## Contact information

- **Practice address:** 111 CALUMET AVE SW, DE SMET, SD 57231
- **Practice address phone:** (605) 854-9033
- **Practice address fax:** (605) 854-9114
- **Mailing address:** 2701 S MINNESOTA AVE STE 1, SIOUX FALLS, SD 57105-4746
- **Mailing address phone:** (605) 367-2800
- **Mailing address fax:** (605) 367-2876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 100-1879 | SD | — |
| 3336C0003X | Community/Retail Pharmacy | 100-1879 | SD | Yes |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 102113 | IMMUNIZATION - LEGACY | SD |
| 05 | — | 8504430 | — | SD |