Provider Demographics
NPI:1386673408
Name:ACIG LLC
Entity Type:Organization
Organization Name:ACIG LLC
Other - Org Name:DOSCH FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:605-284-2752
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:SD
Mailing Address - Zip Code:57437-0707
Mailing Address - Country:US
Mailing Address - Phone:605-284-2682
Mailing Address - Fax:605-284-5142
Practice Address - Street 1:207 J AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:EUREKA
Practice Address - State:SD
Practice Address - Zip Code:57437-0707
Practice Address - Country:US
Practice Address - Phone:605-284-2752
Practice Address - Fax:605-284-5142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD100-0482332B00000X, 3336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8502130Medicaid
SD9167300Medicaid
SD9167300Medicaid