Healthcare Provider Details

I. General information

NPI: 1871687905
Provider Name (Legal Business Name): GBANK HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 1ST ST NE
MOUNT VERNON IA
52314-1422
US

IV. Provider business mailing address

101 1ST ST NE
MOUNT VERNON IA
52314-1422
US

V. Phone/Fax

Practice location:
  • Phone: 319-895-6248
  • Fax: 319-895-6991
Mailing address:
  • Phone: 319-895-6348
  • Fax: 319-895-6991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. AMANDA RENEE MULL
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMD
Phone: 563-505-3528