| NPI | 1871535104 |
|---|---|
| Doing Business As | WARD EAST SIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | GREGORY JOHANSEN President 515-440-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 1457) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2015-05-07 |