Crissman Drug

Primary specialty

PharmacyTaxonomy code 333600000X

License

10000003 Issued in SD

Legal business name

CRISSMAN DRUG

Practice address

33 Main St
Ipswich, SD 57451

Phone

(605) 426-6551

Fax

(605) 426-6321

NPI assigned

Aug 10, 2006

Last updated

Oct 17, 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

Dr. Judy Waldman, PHARMD

Title

Owner

Phone

(605) 426-6551

Specialties & licenses 4

Addresses

Other identifiers 3

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1962413534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36",
            "address_2": "33 MAIN ST",
            "city": "IPSWICH",
            "state": "SD",
            "postal_code": "574510036",
            "telephone_number": "605-426-6551",
            "fax_number": "605-426-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MAIN ST",
            "city": "IPSWICH",
            "state": "SD",
            "postal_code": "57451",
            "telephone_number": "605-426-6551",
            "fax_number": "605-426-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISSMAN DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "WALDMAN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-426-6551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "SD",
            "license": "10000003",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8500872",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4301470",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9161382",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy L Artz, PTA
• Avera St. Luke's (Avera Medical Group Ipswich)
• Jenae Barnhart
• City of Ipswich
• Eureka Pharmacy & Gift Shoppe Inc (Vilas Pharmacy)
• Lacey Lynn Galbraith, PT
• Ipswich Care and Rehabilitation Center LLC (Ipswich Care and Rehabilitation Center)
• Ipswich Public School District #22-6
• Ipswich SD Skilled Nursing Facility LLC (Avantara Ipswich)

• Pharmacy in Ipswich, SD
• Providers in Ipswich, SD by specialty
• Pharmacy in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.