Organization Active NPI

Yankton Drug Co Inc

  • Community/Retail Pharmacy
  • Yankton, SD
National Provider Identifier
1013022052
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1000473 Issued in SD
Legal business name
YANKTON DRUG CO INC
Practice address
109 W 3Rd St
Yankton, SD 57078-4320
Phone
(605) 665-7865
Fax
(605) 665-0452
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Kuchta
Title
Terminated
Phone
(605) 665-7865

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1000473 SD Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

109 W 3Rd St
Yankton, SD 57078-4320

Mailing address

109 W 3Rd St
Yankton, SD 57078-4320
Phone (605) 665-7865

Other identifiers 2

IdentifierTypeStateIssuer
2093933OtherPK
8500250MedicaidSD

Other names 1

  • YANKTON REXALL DRUG Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090827000120 SD Part B Supplier - Mass Immunization (Roster Biller Only) 5193870111 Practice locations: Yankton, SD
O20100930000622 SD DME Supplier - Pharmacy 5193870111 Practice locations: Yankton, SD

National Provider Directory

National Provider Directory
Tax ID family
Yankton Drug Company2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

109 W 3rd St
Yankton, SD 57078
Phone (605) 665-7865

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1013022052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 3RD ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784320",
            "telephone_number": "605-665-7865",
            "fax_number": "605-665-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 3RD ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784320",
            "telephone_number": "605-665-7865",
            "fax_number": "605-665-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANKTON DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "KUCHTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "TERMINATED",
        "authorized_official_telephone_number": "605-665-7865"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SD",
            "license": "1000473",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093933",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8500250",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YANKTON REXALL DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YANKTON REXALL DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.