Healthcare Provider Details

I. General information

NPI: 1104852318
Provider Name (Legal Business Name): UNION DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 HIGHWAY 150 N
WEST UNION IA
52175-1048
US

IV. Provider business mailing address

315 HIGHWAY 150 N
WEST UNION IA
52175-1048
US

V. Phone/Fax

Practice location:
  • Phone: 563-422-3721
  • Fax: 563-422-3721
Mailing address:
  • Phone: 563-422-3721
  • Fax: 563-422-3721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number56
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STEVEN METCALF
Title or Position: PRESIDENT
Credential: PHARMACY
Phone: 563-422-3721