Healthcare Provider Details

I. General information

NPI: 1194887919
Provider Name (Legal Business Name): ALLIMONT PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S. MAIN ST.
CLARKSVILLE IA
50619
US

IV. Provider business mailing address

PO BOX 626
CLARKSVILLE IA
50619-0626
US

V. Phone/Fax

Practice location:
  • Phone: 319-278-4476
  • Fax: 319-278-4966
Mailing address:
  • Phone: 319-278-4476
  • Fax: 319-278-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number844
License Number StateIA

VIII. Authorized Official

Name: JOAN MOAD
Title or Position: PHARMACIST
Credential:
Phone: 319-278-4476