Provider Demographics
NPI:1083305437
Name:3 C PHARMACY INC
Entity Type:Organization
Organization Name:3 C PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:WESTLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:605-723-5920
Mailing Address - Street 1:600 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-1419
Mailing Address - Country:US
Mailing Address - Phone:605-723-5920
Mailing Address - Fax:605-723-4010
Practice Address - Street 1:600 STATE ST
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-1419
Practice Address - Country:US
Practice Address - Phone:605-723-5920
Practice Address - Fax:605-723-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD2019349Medicaid
WY156274600Medicaid