Kevin Glenn Wurtz
Organization Active NPI Community/Retail Pharmacy · Elk Point, SD
NPI 1306911599 · NPPES record last updated Aug 19, 2009
Key facts
- NPI
- 1306911599
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 100-0510 (SD)
- Legal business name
- KEVIN GLENN WURTZ
- Practice address
- 107 E Main St
Elk Point, SD 57025 - Phone
- (605) 356-3336
- Fax
- (605) 356-3202
- NPI assigned
- Nov 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Kevin Wurtz, RPH
- Title
- Owner
- Phone
- (605) 356-3336
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 100-0510 | SD | Yes |
Addresses
Primary practice location
107 E Main St
Elk Point, SD 57025
Mailing address
PO Box 489
Elk Point, SD 57025-0489
Phone (605) 356-3336
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8500840 | Medicaid | SD | |
| 4301191 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- PIONEER DRUG
Other providers in Elk Point, SD
- Jacqueline Kay Holgate
- Horizon Health Care Inc
- Erik Neil Johnson
- Johnson'S Chiropractic Clinic, P.C.
- Marie Kaiser
- Key Rehabilitation, Inc
- Kismet Elk LLC
- Kismet Elk LLC
- Matthew John McDermott
- Traci McDonald
All providers in Elk Point, SD · Community/Retail Pharmacy in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.