Individual
TIMOTHY ERIC SASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
111 WASHINGTON AVE NW, WAGNER, SD 57380
(605) 384-3621
(605) 384-3293
Mailing address
111 WASHINGTON AVE NW, WAGNER, SD 57380
(605) 384-3621
(605) 384-3293
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13008
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5540030
—
SD
05
—
5540100
—
SD
05
—
5540280
—
SD
01
—
HSZ059
MEDICARE
—
Enumeration date
10/02/2008
Last updated
10/02/2008
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