Provider Demographics
NPI:1851174031
Name:VILAS PHARMACY
Entity Type:Organization
Organization Name:VILAS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:SPERRY
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:57501-1215
Mailing Address - Country:US
Mailing Address - Phone:605-224-4538
Mailing Address - Fax:605-224-8027
Practice Address - Street 1:145 GLENDALE DR STE 5
Practice Address - Street 2:
Practice Address - City:LEAD
Practice Address - State:SD
Practice Address - Zip Code:57754-1500
Practice Address - Country:US
Practice Address - Phone:605-717-2496
Practice Address - Fax:605-717-2497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WYODAK PHARMACIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy