Provider Demographics
NPI:1629476270
Name:COMMUNITY PHARMACIES INC
Entity Type:Organization
Organization Name:COMMUNITY PHARMACIES INC
Other - Org Name:VILAS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-224-4538
Mailing Address - Street 1:PO BOX 1215
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-0000
Mailing Address - Country:US
Mailing Address - Phone:605-224-4538
Mailing Address - Fax:605-522-8027
Practice Address - Street 1:224 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:SUNDANCE
Practice Address - State:WY
Practice Address - Zip Code:82729-0547
Practice Address - Country:US
Practice Address - Phone:307-283-3883
Practice Address - Fax:307-283-3884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYR101393336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY139178000Medicaid