| NPI | 1295842839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MCCLIMON Manager 563-872-4259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IA 494) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IA 494) |
| 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: IA 494) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-01-21 |