Healthcare Provider Details

I. General information

NPI: 1396846192
Provider Name (Legal Business Name): HEIDI JO PRICE-EASTMAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 UNIVERSITY AVE STE 105
DES MOINES IA
50314-2355
US

IV. Provider business mailing address

10834 N 99TH AVE W
COLLINS IA
50055-8543
US

V. Phone/Fax

Practice location:
  • Phone: 515-248-1550
  • Fax:
Mailing address:
  • Phone: 515-210-8480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17190
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17190
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: