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General NPI Number Information
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NPI Number | 1063491488
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Entity Type | Organization
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Legal Business Name | CENTRAL CITY FAMILY PHARMACY, INC
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 401 CARDINAL AVE
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City | ATKINS
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State | IA
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Zip | 52206-4701
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Country | US
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Telephone | 319-446-6231
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Fax | 319-446-3232
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Provider Business Mailing Address
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Address Line | 401 CARDINAL AVE
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City | ATKINS
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State | IA
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Zip | 52206-4701
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Country | US
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Telephone | 319-446-6231
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Fax | 319-446-3232
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Authorized Official
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Title or Position | OWNER
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Name | MS. MEGAN MANDERSCHEID
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Credential | PHARMD
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Telephone | 319-438-1988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 694
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License Number State | IA
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