Provider Demographics
NPI:1528380862
Name:COMMUNITY PHARMACIES INC.
Entity Type:Organization
Organization Name:COMMUNITY PHARMACIES INC.
Other - Org Name:VILAS PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:605-967-2123
Mailing Address - Street 1:PO BOX 637
Mailing Address - Street 2:
Mailing Address - City:FAITH
Mailing Address - State:SD
Mailing Address - Zip Code:57626-0637
Mailing Address - Country:US
Mailing Address - Phone:605-967-2123
Mailing Address - Fax:605-967-2910
Practice Address - Street 1:100 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FAITH
Practice Address - State:SD
Practice Address - Zip Code:57626-0637
Practice Address - Country:US
Practice Address - Phone:605-967-2123
Practice Address - Fax:605-967-2910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD100-19563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8504620Medicaid