Healthcare Provider Details

I. General information

NPI: 1174515001
Provider Name (Legal Business Name): STANGEL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 IOWA AVE
ONAWA IA
51040-1629
US

IV. Provider business mailing address

821 IOWA AVE
ONAWA IA
51040-1629
US

V. Phone/Fax

Practice location:
  • Phone: 712-423-1131
  • Fax: 712-423-3214
Mailing address:
  • Phone: 712-423-1131
  • Fax: 712-423-3214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number574
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AARON STANGEL
Title or Position: VICE PRESIDENT
Credential:
Phone: 712-423-1131