William C Charles, PHARMD

Individual provider Active NPI Pharmacotherapy Pharmacist · Pine Ridge, SD

NPI 1780116665 · NPPES record last updated Mar 30, 2017

Key facts

NPI
1780116665
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacotherapy Pharmacist 1835P1200X
License
20206 (MD)
Practice address
Hwy 18
Pine Ridge, SD 57770
Phone
(605) 867-5131
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
No

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
20206MDMDPharmacotherapy Pharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 20206 MD Yes

Addresses

Primary practice location

Hwy 18
Pine Ridge, SD 57770

Mailing address

PO Box 1201
East Highway 18
Pine Ridge, SD 57770

Other providers in Pine Ridge, SD

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

Sources for this page

Verify at the official NPI Registry.