Healthcare Provider Details

I. General information

NPI: 1902013923
Provider Name (Legal Business Name): FOODS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 MERLE HAY RD
DES MOINES IA
50310-1411
US

IV. Provider business mailing address

4343 MERLE HAY RD
DES MOINES IA
50310-1411
US

V. Phone/Fax

Practice location:
  • Phone: 515-276-4845
  • Fax: 515-331-3163
Mailing address:
  • Phone: 515-276-4845
  • Fax: 515-331-3163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number293
License Number StateIA

VIII. Authorized Official

Name: MARILYN J ALDRICH
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 515-276-4845