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MR. WILLIAM J ROTH
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1467438960
Individual Registrant:MR. WILLIAM J ROTH
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
300 N MAIN ST SALEM, SD 57058 US
Tel: 605-425-2827 Fax: 605-425-2052
Tel: 605-425-2827 Fax: 605-425-2052
Contact information for business:
PO BOX 316 SALEM, SD 57058-0316 US
Tel: 605-425-2827 Fax: 605-425-2052
Tel: 605-425-2827 Fax: 605-425-2052
Registration Information:
NPI: 1467438960
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | SD | 4018 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 8502580 | SD | 05 |
