| NPI | 1679615314 |
|---|---|
| Doing Business As | SAMPLE PEDIATRIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | HARRIETT A MORRIS President 319-377-1533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 333600000X Pharmacy (Licence: IA 865) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 865) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: IA 865) | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IA 865) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |