Charles Debo, PHARMD

Individual provider Active NPI Pharmacist · Pine Ridge, SD

NPI 1225609159 · NPPES record last updated Jul 1, 2021

Key facts

NPI
1225609159
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PHA.0023068 (CO)
Practice address
PHS Indian Hospital
607 Indian Health Road
Pine Ridge, SD 57770
Phone
(605) 867-3192
NPI assigned
Jul 1, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PHA.0023068COMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHA.0023068 CO Yes

Addresses

Primary practice location

PHS Indian Hospital
607 Indian Health Road
Pine Ridge, SD 57770

Mailing address

PHS Indian Hospital
607 Indian Health Road
Pine Ridge, SD 57770

Other providers in Pine Ridge, SD

All providers in Pine Ridge, SD · Pharmacist in South Dakota

Sources for this page

Verify at the official NPI Registry.