Bruce Cornish

Individual provider Active NPI Pharmacist · Sioux Falls, SD

NPI 1013301449 · NPPES record last updated Mar 24, 2015

Key facts

NPI
1013301449
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
5478 (SD)
Practice address
2503 E 54TH St N
Sioux Falls, SD 57104-5563
Phone
(605) 978-3900
NPI assigned
Mar 24, 2015
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
22163IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripharm, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5478 SD Yes
Pharmacist 183500000X 22163 IA

Addresses

Primary practice location

2503 E 54TH St N
Sioux Falls, SD 57104-5563

Mailing address

2503 E 54TH St N
Sioux Falls, SD 57104-5563

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Pharmacist in South Dakota

Sources for this page

Verify at the official NPI Registry.