# HARTFORD PHARMACY LLC

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

## Provider details

- **NPI number:** 1922041680
- **Authorized official:** MR. VINCENT GERARD REILLY RPH (MEMBER MANAGER)
- **Authorized official phone:** (605) 528-2000

## Contact information

- **Practice address:** 304 W. HIGHWAY 38, SUITE 102, HARTFORD, SD 57033-0397
- **Practice address phone:** (605) 528-2000
- **Practice address fax:** (605) 528-2003
- **Mailing address:** PO BOX 397, HARTFORD, SD 57033-0397
- **Mailing address phone:** (605) 528-2000
- **Mailing address fax:** (605) 528-2003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 100-1873 | SD | Yes |

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4353746 | NCPDP \# | SD |
| 05 | — | 8504260 | — | SD |