Provider Demographics
NPI:1144520149
Name:ABRAHAMSON, DON G (RPH)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:G
Last Name:ABRAHAMSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 NORTH AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1249
Mailing Address - Country:US
Mailing Address - Phone:605-642-4747
Mailing Address - Fax:
Practice Address - Street 1:1606 NORTH AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1249
Practice Address - Country:US
Practice Address - Phone:605-642-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR4344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist