Provider Demographics
NPI:1356402598
Name:ENDRES, ANN MARIE (RPH)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:ENDRES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 S SERENITY DR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-8324
Mailing Address - Country:US
Mailing Address - Phone:605-882-7177
Mailing Address - Fax:
Practice Address - Street 1:1320 9TH AVE SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-5302
Practice Address - Country:US
Practice Address - Phone:605-886-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist