Dakota Compounding Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

1001922 Issued in SD

Legal business name

DAKOTA COMPOUNDING PHARMACY

Practice address

628 Main Ave
Ste C
Brookings, SD 57006-1423

Phone

(605) 692-7992

Fax

(605) 692-2118

NPI assigned

Feb 15, 2007

Last updated

Sep 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawn Fokken, RPH

Title

Owner

Phone

(605) 692-7992

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1154464212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 MAIN AVE",
            "address_2": "STE C",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 MAIN AVE",
            "address_2": "STE C",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061423",
            "telephone_number": "605-692-7992",
            "fax_number": "605-692-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "FOKKEN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-692-7992",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "SD",
            "license": "1001922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4353998",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4353998",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn A Culhane
• Dana Culver, RPH
• Kara Cunningham, PT
• Erik Curry
• CVS Pharmacy Inc (CVS Pharmacy #17961)
• Dakotahaven, LLC
• Angela Bunkers Daly
• Karena Leann Damm
• Ashley Daniels, PTA
• Danielle Marie Delaney, CNP

• Compounding Pharmacy in Brookings, SD
• Providers in Brookings, SD by specialty
• Compounding Pharmacy in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.