Healthcare Provider Details

I. General information

NPI: 1992805790
Provider Name (Legal Business Name): CHRIS M SIMPSON R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E CENTER ST
CONRAD IA
50621
US

IV. Provider business mailing address

209 N VERNON ST PO BOX 608
CONRAD IA
50621
US

V. Phone/Fax

Practice location:
  • Phone: 641-366-2441
  • Fax:
Mailing address:
  • Phone: 641-366-3153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17662
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: