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General NPI Number Information
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NPI Number | 1124102801
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Entity Type | Organization
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Legal Business Name | B&R STORES, INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 1320 E EUCLID AVE
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City | DES MOINES
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State | IA
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Zip | 50316-1205
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Country | US
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Telephone | 515-265-5946
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Fax | 515-264-8344
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Provider Business Mailing Address
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Address Line | 4554 W ST
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City | LINCOLN
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State | NE
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Zip | 68503-2831
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Country | US
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Telephone | 402-464-6297
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Fax | 402-434-5732
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | ANTHONY SCHMID
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Credential |
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Telephone | 402-464-6297
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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 | 1529
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License Number State | IA
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