Healthcare Provider Details

I. General information

NPI: 1013846427
Provider Name (Legal Business Name): PHARMA340 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 W MAIN ST
LAKE CITY IA
51449-1585
US

IV. Provider business mailing address

1321 W MAIN ST
LAKE CITY IA
51449-1585
US

V. Phone/Fax

Practice location:
  • Phone: 712-464-7281
  • Fax:
Mailing address:
  • Phone: 712-464-7281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TANIKA STERLING
Title or Position: CPHT. OPERATIONS COORDINATOR
Credential:
Phone: 515-280-2917