Jeff Dixon

Individual provider Active NPI Pharmacist · Eagle Butte, SD

NPI 1063976025 · NPPES record last updated Jan 24, 2019

Key facts

NPI
1063976025
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PS56146 (FL)
Practice address
Cheyenne River Health Center 24276 Airport Rd., 166TH S
Eagle Butte, SD 57625
Phone
(605) 964-1520
NPI assigned
Jan 24, 2019
Sex
Male
Sole proprietor
No

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
PS56146FLMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS56146 FL Yes

Addresses

Primary practice location

Cheyenne River Health Center 24276 Airport Rd., 166TH S
Eagle Butte, SD 57625

Mailing address

24276 Airport Rd., 166TH Street
Eagle Butte, SD 57625
Phone (605) 964-1520

Other providers in Eagle Butte, SD

All providers in Eagle Butte, SD · Pharmacist in South Dakota

Sources for this page

Verify at the official NPI Registry.