Deborah Jean Odens, P.D.

Individual provider Active NPI Pharmacist · Lower Brule, SD

NPI 1104952282 · NPPES record last updated Jul 10, 2012

Key facts

NPI
1104952282
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
R4362 (SD)
Practice address
601 Gall St.
Lower Brule, SD 57548
Phone
(605) 473-8227
Fax
(605) 473-0708
NPI assigned
Feb 26, 2007
Sex
Female
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
R4362SDMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X R4362 SD Yes

Addresses

Primary practice location

601 Gall St.
Lower Brule, SD 57548

Mailing address

712 N Main St
Chamberlain, SD 57325-1271
Phone (605) 234-5833

Other identifiers

IdentifierTypeStateIssuer
R4362OtherSDPHARMACY LICENSE

Other providers in Lower Brule, SD

All providers in Lower Brule, SD · Pharmacist in South Dakota

Sources for this page

Verify at the official NPI Registry.