| NPI | 1700144128 |
|---|---|
| Doing Business As | MIDWEST COMPOUNDING |
| Entity Type | Organization |
| Authorized Contact | GREGORY J JOHANSEN President/Owner 515-440-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: IA 1105) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-02-28 |