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NPI Code Detail

MEDICARE: RYAN PHARMACY INC

MEDICARE: RYAN PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy705IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22028084OTHERPK

General Provider Information

NPI Number : 1609811892
Entity Type Code : Organization
Provider Name (Legal Business Name) : RYAN PHARMACY INC
Provider Business Mailing Address
First Line : 1600 1ST ST E
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-3155
Country : US
Telephone Number : 319-334-7171
Fax Number : 319-334-7074
Provider Business Practice Location Address
First Line : 1600 1ST ST E
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-3155
Country : US
Telephone Number : 319-334-7171
Fax Number : 319-334-7074
Authorized Official
Title or Position : OWNER
Name : KERRY RYAN
Credential :
Telephone Number : 319-334-7171
Provider Enumeration Date : 06/19/2006
Last Update Date : 03/11/2019

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Directions to “RYAN PHARMACY INC ” Practice Location

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