Hoffman Drug Inc
Organization Active NPI Pharmacy · Platte, SD
NPI 1376589176 · NPPES record last updated Oct 19, 2016
Key facts
- NPI
- 1376589176
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 100-0474 (SD)
- Legal business name
- HOFFMAN DRUG INC
- Practice address
- 408 Main St
Platte, SD 57369-0110 - Phone
- (605) 337-3662
- Fax
- (605) 337-2673
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Tiffany Maydew
- Title
- Owner/President
- Phone
- (605) 337-3662
Corporate family (same tax ID) 1
Practitioners 2
-
Bret J. Maydew, PHARM.D.
-
Tiffany Jo Maydew, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160610001964 | SD | DME Supplier - Pharmacy | 1557651080 | Practice locations: Platte, SD |
| O20161020000874 | SD | Part B Supplier - Mass Immunization (Roster Biller Only) | 1557651080 | Practice locations: Platte, SD |
National Provider Directory
- Tax ID family
- Hoffman Drug
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 100-0474 | SD | Yes |
| Community/Retail Pharmacy | 3336C0003X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
408 Main St
Platte, SD 57369-0110
Mailing address
PO Box 110
Platte, SD 57369-0110
Phone (605) 337-3662
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2159004 | Other | PK |
Other names
- Hoffman Drug
Other providers in Platte, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.