Organization
TK DISPENSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE PETERS (OWNER)
(605) 384-3129
Entity
Organization
Contact information
Practice address
29416 402ND AVE, WAGNER, SD 57380-6914
(605) 384-3129
Mailing address
29416 402ND AVE, WAGNER, SD 57380-6914
(605) 384-3129
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9566890
—
SD
Enumeration date
12/15/2006
Last updated
08/22/2020
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