Organization
PARKER PHARMACY, LLC
Active
Other names
Parker Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS PONCELET (OWNER)
(605) 630-0908
Entity
Organization
Contact information
Practice address
27516 SD HIGHWAY 19 STE 2, PARKER, SD 57053-5633
(605) 297-3235
(605) 297-5594
Mailing address
PO BOX 519, PARKER, SD 57053-0519
(605) 297-3235
(605) 297-5594
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
100-1979
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4300365
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/06/2006
Last updated
04/02/2013
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