Provider Demographics
NPI:1164308078
Name:ANDERSON PHARMACY INC
Entity type:Organization
Organization Name:ANDERSON PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:605-987-2661
Mailing Address - Street 1:303 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:SD
Mailing Address - Zip Code:57013-1735
Mailing Address - Country:US
Mailing Address - Phone:605-987-2661
Mailing Address - Fax:605-987-2478
Practice Address - Street 1:303 E 5TH ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:SD
Practice Address - Zip Code:57013-1735
Practice Address - Country:US
Practice Address - Phone:605-987-2661
Practice Address - Fax:605-987-2478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy