Healthcare Provider Details

I. General information

NPI: 1013207661
Provider Name (Legal Business Name): FOODS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2011
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 GRAND AVE
AMES IA
50010-4384
US

IV. Provider business mailing address

3121 GRAND AVE
AMES IA
50010-4384
US

V. Phone/Fax

Practice location:
  • Phone: 515-817-2879
  • Fax: 515-233-5499
Mailing address:
  • Phone: 515-817-2879
  • Fax: 515-233-5499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1389
License Number StateIA

VIII. Authorized Official

Name: MRS. MARILYN ALDRICH
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 515-276-4845