Provider Demographics
NPI:1770664708
Name:STOREY, HEATHER RAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RAE
Last Name:STOREY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-2610
Mailing Address - Country:US
Mailing Address - Phone:605-366-0118
Mailing Address - Fax:605-367-2850
Practice Address - Street 1:2701 S MINNESOTA AVE STE 1
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4746
Practice Address - Country:US
Practice Address - Phone:605-367-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR5086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist