| NPI | 1831409846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FULLER President 515-321-7644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 1130) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2010-10-12 |
| Last Update Date | 2024-12-17 |