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General NPI Number Information
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NPI Number | 1063562890
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Entity Type | Organization
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Legal Business Name | ESTHERVILLE PHARMACY, L.L.C.
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 1804 CENTRAL AVE
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City | ESTHERVILLE
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State | IA
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Zip | 51334-2465
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Country | US
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Telephone | 712-362-0330
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Fax | 712-362-0331
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Provider Business Mailing Address
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Address Line | 1804 CENTRAL AVE
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City | ESTHERVILLE
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State | IA
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Zip | 51334-2465
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Country | US
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Telephone | 712-362-0330
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Fax | 712-362-0331
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDA OLSEN
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Credential |
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Telephone | 712-243-2110
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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