Mack, Latilia Deanne

Mack, Latilia Deanne is an individual health care provider with primary practice located at 24276 166Th St Airport Rd, Eagle Butte SD 57625. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Mack, Latilia Deanne can be contacted via phone (605) 964-0650.

Contact Information

Primary practice address
24276 166Th St Airport Rd Eagle Butte SD 57625
Phone: (605) 964-0650
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X RPH024746 Georgia

Profile Details

NPI number 1295082840
LBN Legal business name Mack, Latilia Deanne
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2012
Last updated Aug 13th, 2012 - about 14 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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