# WYODAK PHARMACIES INC

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

## Provider details

- **NPI number:** 1902253214
- **Authorized official:** JAMES ROBERT STEPHENS RPH (OWNER, PHARMACIST)
- **Authorized official phone:** (605) 224-4538

## Contact information

- **Practice address:** 145 GLENDALE DR, LEAD, SD 57754
- **Practice address phone:** (605) 717-2496
- **Practice address fax:** (605) 717-2497
- **Mailing address:** 145 GLENDALE DR, LEAD, SD 57754
- **Mailing address phone:** (605) 717-2496
- **Mailing address fax:** (605) 717-2497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 100-2042 | SD | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/17/2016
- **Last updated:** 09/14/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1902253214 | — | SD |
| 01 | — | 2160047 | PK | — |