Sdsu Jackrabbit Pharmacy

LBN: Sdsu Jackrabbit Pharmacy
Sdsu Jackrabbit Pharmacy is an health care organization with primary practice located at N Campus Dr Sdsu Wellness Center Room 119, Brookings SD 57007-0001. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Institutional Pharmacy. Suppliers / Institutional Pharmacy is the primary health care specialty. Sdsu Jackrabbit Pharmacy can be contacted via phone (605) 688-5410, or through Willis, Michaela via phone (605) 688-4493.

Contact Information

Primary practice address
N Campus Dr Sdsu Wellness Center Room 119 Brookings SD 57007-0001
Phone: (605) 688-5410
Fax: (605) 688-5267
Website:
Map and Directions
Authorized official contact:
Name: Willis, Michaela
Phone: (605) 688-4493

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Institutional Pharmacy 3336I0012X 100-0492 South Dakota

Profile Details

NPI number 1124177100
LBN Legal business name Sdsu Jackrabbit Pharmacy
DBA Doing business as Sdsu Jackrabbit Pharmacy
Authorized official Willis, Michaela
Entity Organization
Organization subpart 1 No
Enumeration date Jan 9th, 2007
Last updated Dec 28th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124177100 NPPES
Other 2093681 PK

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