Provider Demographics
NPI:1972561520
Name:DAKOTA DRUG AND JEWELRY,INC
Entity Type:Organization
Organization Name:DAKOTA DRUG AND JEWELRY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF PHARM.
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHAMBER
Authorized Official - Suffix:
Authorized Official - Credentials:REG PHARMACIST
Authorized Official - Phone:605-256-4521
Mailing Address - Street 1:123 N EGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-2840
Mailing Address - Country:US
Mailing Address - Phone:605-256-4521
Mailing Address - Fax:605-256-9208
Practice Address - Street 1:123 N EGAN AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-2840
Practice Address - Country:US
Practice Address - Phone:605-256-4521
Practice Address - Fax:605-256-9208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1000967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4300391OtherNABP NUMBER
SD8500670Medicaid