Provider Demographics
NPI:1598366130
Name:DUFOUR, AIMEE C (PHARM D)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:C
Last Name:DUFOUR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N LACROSSE ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6965
Mailing Address - Country:US
Mailing Address - Phone:605-342-0881
Mailing Address - Fax:
Practice Address - Street 1:1200 N LACROSSE ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6965
Practice Address - Country:US
Practice Address - Phone:605-342-0881
Practice Address - Fax:605-342-0716
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist