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Organization
WYODAK PHARMACIES INC
Active
Organization
WYODAK PHARMACIES INC
Active
Other names
VILAS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ROBERT STEPHENS RPH (OWNER, PHARMACIST)
(605) 224-4538
Entity
Organization
Contact information
Practice address
145 GLENDALE DR, LEAD, SD 57754
(605) 717-2496
(605) 717-2497
Mailing address
145 GLENDALE DR, LEAD, SD 57754
(605) 717-2496
(605) 717-2497
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
100-2042
SD
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902253214
—
SD
01
—
2160047
PK
—
Enumeration date
05/17/2016
Last updated
09/14/2020
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