Healthcare Provider Details

I. General information

NPI: 1295644169
Provider Name (Legal Business Name): MADELINE DYER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 LOGAN AVE
WATERLOO IA
50703-9900
US

IV. Provider business mailing address

8721 W 12TH ST
CEDAR FALLS IA
50613-9127
US

V. Phone/Fax

Practice location:
  • Phone: 319-235-3941
  • Fax:
Mailing address:
  • Phone: 319-235-3941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25603
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: