| NPI | 1609149749 |
|---|---|
| Doing Business As | WIDNER DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | JONATHAN KALLENBACH Owner Pharmacist In Charge 563-927-4463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IA 188) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2018-05-16 |