Healthcare Provider Details

I. General information

NPI: 1487271136
Provider Name (Legal Business Name): THOMAS J DEVANEY PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TOM DEVANEY PHARMACIST

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E 3RD ST
ANAMOSA IA
52205-2066
US

IV. Provider business mailing address

303 W MAIN ST
ANAMOSA IA
52205-1190
US

V. Phone/Fax

Practice location:
  • Phone: 319-462-3306
  • Fax: 319-462-6065
Mailing address:
  • Phone: 319-462-3306
  • Fax: 319-462-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16654
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: