43D2176384 CLIA NUMBER - PRAIRIE HILLS PHARMACY

Laboratory Demographics

CLIA Number: 43D2176384

Facility Name: PRAIRIE HILLS PHARMACY

Facility Address:
319 SUMMIT ST
BELLE FOURCHE, SD
ZIP 57717
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Facility Phone Number: 605 723-5920

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1497310551

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	43D2176384
LAB Type	Pharmacy
Facility Name	PRAIRIE HILLS PHARMACY
Street	319 SUMMIT ST
City	BELLE FOURCHE
State	SD
ZIP	57717
Phone	605 723-5920
CertificateType	4
CertificateEffectiveDate	12/13/2023
CertificateExpirationDate	12/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024