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General NPI Number Information
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NPI Number | 1013040674
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Entity Type | Individual
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Provider Name | GENEROSA D ARCHER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 404 E EUCLID AVE
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City | INDIANOLA
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State | IA
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Zip | 50125-1730
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Country | US
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Telephone | 515-962-9399
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Fax | 515-962-2202
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Provider Business Mailing Address
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Address Line | 1209 S 3RD STREET
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City | INDIANOLA
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State | IA
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Zip | 50125
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Country | US
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Telephone | 918-413-2428
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Fax | 515-962-2202
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21325
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13483
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License Number State | OK
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