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General NPI Number Information
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NPI Number | 1003974817
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Entity Type | Organization
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Legal Business Name | MANSMITH PHARMACY INC.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 3204 1ST ST
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City | EMMETSBURG
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State | IA
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Zip | 50536-2515
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Country | US
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Telephone | 712-852-2727
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Fax | 712-852-2975
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Provider Business Mailing Address
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Address Line | 3204 1ST ST
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City | EMMETSBURG
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State | IA
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Zip | 50536-2515
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Country | US
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Telephone | 712-852-2727
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Fax | 712-852-2975
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. MARK M. ANLIKER
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Credential | PHARMACIST
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Telephone | 712-852-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 764
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License Number State | IA
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