Healthcare Provider Details

I. General information

NPI: 1629913041
Provider Name (Legal Business Name): ANDREA AUDREY NEUBAUER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MONTGOMERY ST
DECORAH IA
52101-2364
US

IV. Provider business mailing address

901 MONTGOMERY ST
DECORAH IA
52101-2364
US

V. Phone/Fax

Practice location:
  • Phone: 563-382-1033
  • Fax: 563-387-3111
Mailing address:
  • Phone: 563-382-1033
  • Fax: 563-387-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23105
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: