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Organization

BROTHERS PHARMACIES INC

Active
Other names
Shane's Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
SHANE CLARAMBEAU (CEO/PRESIDENT)
(605) 223-9200
Entity
Organization

Contact information

Practice address
213 E HUSTAN AVE STE A, FORT PIERRE, SD 57532
(605) 223-9200
(605) 223-9201
Mailing address
213 E HUSTAN AVE STE A, FORT PIERRE, SD 57532
(605) 223-9200
(605) 223-9201

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
100-1897
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2166389
PK
05
8504350
SD
Enumeration date
12/01/2016
Last updated
08/06/2021
About Stedi
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  • Eligibility checks
  • EDI platform