South Street Pharmacy, Llc

LBN: South Street Pharmacy, Llc
South Street Pharmacy, Llc is an health care organization with primary practice located at 1456 South St , Wheatland WY 82201-2736. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy. Suppliers / Pharmacy is the primary health care specialty. South Street Pharmacy, Llc can be contacted via phone (307) 322-2486, or through Geile, Corinda L via phone (307) 322-2486.

Contact Information

Primary practice address
1456 South St Wheatland WY 82201-2736
Phone: (307) 322-2486
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Geile, Corinda L RPH
Phone: (307) 322-2486

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X R10063 Wyoming

Profile Details

NPI number 1639482532
LBN Legal business name South Street Pharmacy, Llc
DBA Doing business as
Authorized official Geile, Corinda L RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 20th, 2010
Last updated Aug 21st, 2013 - about 11 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 1639482532 NPPES
Wyoming MEDICAID 129737600

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