# PARKER PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Parker Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750450961
- **Authorized official:** CHRIS PONCELET (OWNER)
- **Authorized official phone:** (605) 630-0908

## Contact information

- **Practice address:** 27516 SD HIGHWAY 19 STE 2, PARKER, SD 57053-5633
- **Practice address phone:** (605) 297-3235
- **Practice address fax:** (605) 297-5594
- **Mailing address:** PO BOX 519, PARKER, SD 57053-0519
- **Mailing address phone:** (605) 297-3235
- **Mailing address fax:** (605) 297-5594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 100-1979 | SD | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 04/02/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4300365 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |