| NPI | 1992877518 |
|---|---|
| Doing Business As | FONTANELLE DRUG |
| Entity Type | Organization |
| Authorized Contact | KAYE BAX Pres 641-745-2008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 654) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2017-01-17 |