| NPI | 1942452230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FULLER President 515-321-7644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IA 1222) |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2024-12-17 |