Organization
FAMILY PHARMACY OF MOBRIDGE INC
Active
Other names
FAMILY PHARMACY-CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
LEVI JENSEN (PRESIDENT)
(605) 845-8140
Entity
Organization
Contact information
Practice address
1317 10TH AVE W, MOBRIDGE, SD 57601-1146
(605) 845-8140
(605) 845-8146
Mailing address
1317 10TH AVE W, BOX 759, MOBRIDGE, SD 57601-1146
(605) 845-8140
(605) 845-8146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1001797
SD
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020988
—
ND
01
—
2093771
PK
—
05
—
8501062
—
SD
Enumeration date
09/06/2006
Last updated
02/28/2022
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