Organization
CIGNA TEL DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY DUANE HENNINGS RPH (PHARMACIST)
(605) 373-0100
Entity
Organization
Contact information
Practice address
4901 N 4TH AVE, SIOUX FALLS, SD 57104-0444
(800) 835-3784
Mailing address
1509 CALUMET RD, BROOKINGS, SD 57006-3612
(605) 692-7525
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
4780
SD
Other
Enumeration date
05/01/2007
Last updated
07/09/2008
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