Provider Demographics
NPI:1609317395
Name:BOGEN CORPORATION
Entity type:Organization
Organization Name:BOGEN CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTERKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-679-6826
Mailing Address - Street 1:1120 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-1617
Mailing Address - Country:US
Mailing Address - Phone:605-679-6826
Mailing Address - Fax:605-679-6596
Practice Address - Street 1:1120 E 10TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-1617
Practice Address - Country:US
Practice Address - Phone:605-679-6826
Practice Address - Fax:605-679-6596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
SD100-20473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2168710OtherPK