| NPI | 1205847845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GANSEMER CEO 563-583-7357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: IA F066142) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |