Individual provider · NPI-1

Gordon Scott Budahl, RPh

Pharmacist, Pharmacotherapy · Fort Meade, SD

NPI number1306936307
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1306936307
Entity type
Individual (NPI-1)
Name
Mr. Gordon Scott Budahl
Credential
RPh
Sex
Male
Sole proprietor
No
Enumeration date
Oct 13, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1835P1200X Pharmacist, Pharmacotherapy3773SDYes

Practice location

113 Comanche Rd
Pharmacy Service
Fort Meade, SD 57741-1002

Phone 605-720-7060

Mailing address

1129 Paisley Ter
Sturgis, SD 57785-2007

Phone 605-720-7060

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