| NPI | 1346376530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI MARIE HAVENS Pharmacy Manager 641-444-3451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 632) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2018-10-09 |