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
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