Basic Information
| Provider Information | |||||||||
| NPI: | 1104076801 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLINKEBIEL | ||||||||
| FirstName: | DREW | ||||||||
| MiddleName: | LOUIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 S CLIFF AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053225750 | ||||||||
| FaxNumber: | 6053225799 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 S CLIFF AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053225750 | ||||||||
| FaxNumber: | 6053225799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2008 | ||||||||
| LastUpdateDate: | 04/22/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 119280 | MN | N | Pharmacy Service Providers | Pharmacist | 183500000X | 13130 | NE | N | Pharmacy Service Providers | Pharmacist | 183500000X | 21318 | IA | N | Pharmacy Service Providers | Pharmacist | 183500000X | R6251 | SD | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.