Individual
FORGE PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
EAST HIGHWAY 18, PINE RIDGE INDIAN HOSPITAL, PINE RIDGE, SD 57770
(605) 867-3192
Mailing address
PO BOX 285, PINE RIDGE, SD 57770-0285
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202210760
VA
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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