Organization
WYODAK PHARMACIES INC
Active
Other names
VILAS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ROBERT STEPHENS RPH (OWNER, PHARMACIST)
(605) 224-4538
Entity
Organization
Contact information
Practice address
145 GLENDALE DR, LEAD, SD 57754
(605) 717-2496
(605) 717-2497
Mailing address
145 GLENDALE DR, LEAD, SD 57754
(605) 717-2496
(605) 717-2497
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
100-2042
SD
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902253214
—
SD
01
—
2160047
PK
—
Enumeration date
05/17/2016
Last updated
09/14/2020
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