| NPI | 1184781940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW PLOEHN Owner 563-324-5004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IA 774) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0002X Pharmacy Clinic Pharmacy (Licence: IA 16D0922143) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2024-02-23 |