| NPI | 1699782631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY C HERBERT Phcy Dir 319-398-6730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IA 1285) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2008-07-03 |