Healthcare Provider Details

I. General information

NPI: 1598698151
Provider Name (Legal Business Name): CASANDRA HACKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 60TH ST
WEST DES MOINES IA
50266-7700
US

IV. Provider business mailing address

153 S 91ST ST
WEST DES MOINES IA
50266-4988
US

V. Phone/Fax

Practice location:
  • Phone: 515-343-1700
  • Fax:
Mailing address:
  • Phone: 515-783-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20952
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: