Healthcare Provider Details

I. General information

NPI: 1669865762
Provider Name (Legal Business Name): CAPSTONE PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N JEFFERSON ST
MT PLEASANT IA
52641-2017
US

IV. Provider business mailing address

210 N JEFFERSON ST
MT PLEASANT IA
52641-2017
US

V. Phone/Fax

Practice location:
  • Phone: 319-385-0733
  • Fax: 319-385-0735
Mailing address:
  • Phone: 319-385-0733
  • Fax: 319-385-0735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1511
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. TAN T HO
Title or Position: PHARMACIST/OWNER
Credential: PHARM.D
Phone: 319-321-3236