Family Pharmacy of Mobridge , Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1001796 Issued in SD

Legal business name

FAMILY PHARMACY OF MOBRIDGE , INC

Practice address

323 Main St
Mobridge, SD 57601-2534

Phone

(605) 845-3345

Fax

(605) 845-5462

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sarah Andersen

Title

Owner

Phone

(605) 845-3345

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Family Pharmacy of Mobridge Inc

  dba Family Pharmacy-Clinic

  • Community/Retail Pharmacy
  • Mobridge, SD
  • NPI 1407959539

  1850412230

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Family Pharmacy of Mobridge Inc2 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.

• Family Pharmacy of Mobridge Inc

  dba Family Pharmacy-Clinic

  • Community/Retail Pharmacy
  • Mobridge, SD
  • NPI 1407959539
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane Habbena Dady, PHARMACIST

  • Pharmacist
  • Mobridge, SD
  • NPI 1326035429
  NPD
• J. Mark Dady, RPH

  • Pharmacist
  • Mobridge, SD
  • NPI 1235211772
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1144243270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N MAIN ST",
            "city": "MOBRIDGE",
            "state": "SD",
            "postal_code": "576012534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 MAIN ST",
            "city": "MOBRIDGE",
            "state": "SD",
            "postal_code": "576012534",
            "telephone_number": "605-845-3345",
            "fax_number": "605-845-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY OF MOBRIDGE , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-845-3345",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SD",
            "license": "1001796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8501060",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Dady, FNP-BC
• J. Mark Dady, RPH
• Craig Dockter
• Colette A Ducheneaux, M.D.
• Myranda Elmer, CLC
• Family Pharmacy of Mobridge Inc (Family Pharmacy-Clinic)
• Mary Sue Fonkert, M.S.W., L.C.S.W.
• Karen Fryhling
• Ashley Dawn Geist, LPC-20667-SUPV
• Candida Goehring, C NP

• Community/Retail Pharmacy in Mobridge, SD
• Providers in Mobridge, SD by specialty
• Community/Retail Pharmacy in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.