Organization
DOUGLAS COUNTY MEMORIAL HOSPITAL
Active
Other names
Prairie Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HEATH BROUWER (ADMINISTRATOR)
(605) 724-2151
Entity
Organization
Contact information
Practice address
1311 BRADDOCK AVE, ARMOUR, SD 57313-2136
(605) 724-2970
(605) 724-2310
Mailing address
1311 BRADDOCK AVE, ARMOUR, SD 57313-2136
(605) 724-2970
(605) 724-2310
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1001848
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8502460
—
SD
01
—
9167440
MEDICAID DME
SD
Enumeration date
07/07/2006
Last updated
11/01/2012
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