Healthcare Provider Details

I. General information

NPI: 1770241614
Provider Name (Legal Business Name): ADAM ARICKX PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2021
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 4TH ST SW STE 110
MASON CITY IA
50401-2856
US

IV. Provider business mailing address

1010 4TH ST SW STE 110
MASON CITY IA
50401-2856
US

V. Phone/Fax

Practice location:
  • Phone: 641-428-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20352
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: