Anderberg, Travis Lee

Anderberg, Travis Lee is an individual health care provider with primary practice located at 209 N Broadway Ave , Miller SD 57362-1340. He recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as his primary health care specialty. Anderberg, Travis Lee can be contacted via phone (605) 853-3647.

Contact Information

Primary practice address
209 N Broadway Ave Miller SD 57362-1340
Phone: (605) 853-3647
Fax: (605) 853-3744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X 5327 South Dakota

Profile Details

NPI number 1265543565
LBN Legal business name Anderberg, Travis Lee
Credentials PHARM. D
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265543565 NPPES
South Dakota MEDICAID 8500352

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