Healthcare Provider Details

I. General information

NPI: 1588892764
Provider Name (Legal Business Name): LINDSEY JUNE BOHR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 10TH ST SE
CEDAR RAPIDS IA
52403-1251
US

IV. Provider business mailing address

367 S STEWART ST
NORTH LIBERTY IA
52317-9602
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-6062
  • Fax:
Mailing address:
  • Phone: 563-380-2191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20990
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: