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General NPI Number Information
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NPI Number | 1043985955
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Entity Type | Individual
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Provider Name | NEVIN WILLIAM RADECHEL
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Gender | Male
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 2804 BEAVER AVE
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City | DES MOINES
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State | IA
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Zip | 50310-4038
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Country | US
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Telephone | 515-277-3702
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Fax | 515-277-3703
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Provider Business Mailing Address
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Address Line | 1412 41ST ST
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City | DES MOINES
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State | IA
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Zip | 50311-2520
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Country | US
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Telephone | 515-402-2284
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Fax |
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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 | 24210
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License Number State | IA
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