| NPI | 1134647100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FULLER President 515-321-7644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IA 1615) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2025-09-11 |