NPI 1639482532 · live from the CMS NPI Registry
South Street Pharmacy, LLC
Pharmacy in Wheatland, WY. National Provider Identifier 1639482532, active.
NPI record
| NPI | 1639482532 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy 333600000X |
| Practice location | 1456 South St, Wheatland, WY 82201 |
| Practice phone | 307-322-2486 |
| Enumerated | July 20, 2010 |
| Last updated | August 21, 2013 |
| Authorized official | Corinda Geile, President/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy primary | 333600000X | R10063 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.