Sdsu Jackrabbit Pharmacy
Sdsu Jackrabbit Pharmacy is a healthcare organization registered as Institutional Pharmacy in Brookings, SD, holding Type 2 (organization) NPI 1124177100 since 2007. The authorized official on file is Michaela Willis, Vp for Student Affairs.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1124177100 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Sdsu Jackrabbit Pharmacy |
| Other name | <Unavail> |
| Practice address | N CAMPUS DR, SDSU WELLNESS CENTER ROOM 119, Brookings, SD, 57007 |
| Phone | 6056885410 |
| Fax | 6056885267 |
| Enumeration date | 2007-01-09 |
| Last updated in NPPES | 2021-12-28 |
Authorized official
| Name | Michaela Willis |
|---|---|
| Title | Vp for Student Affairs |
| Phone | 6056884493 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | — | — |
| 3336I0012X | Institutional Pharmacy | Primary | 100-0492 | SD |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2093681 | Other | — | PK |
Copy-ready billing details
Provider: Sdsu Jackrabbit Pharmacy NPI: 1124177100 Taxonomy: 3336I0012X (Institutional Pharmacy) Address: N CAMPUS DR, SDSU WELLNESS CENTER ROOM 119, Brookings, SD, 57007
Verify this record
Cross-check NPI 1124177100 against the authoritative CMS record: view Sdsu Jackrabbit Pharmacy on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Sdsu Jackrabbit Pharmacy?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2021-12-28.