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General NPI Number Information
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NPI Number | 1255778825
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Entity Type | Individual
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Provider Name | LAURA J PELOQUIN RPH, PHARM D.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2013
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 1825 LOGAN AVE RM 551 ALLEN HOSPITAL ANTICOAGULATION CLINIC
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City | WATERLOO
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State | IA
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Zip | 50703-1916
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Country | US
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Telephone | 319-235-3172
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Fax | 319-235-3408
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Provider Business Mailing Address
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Address Line | 7150 SOPPE FARM RD
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City | WASHBURN
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State | IA
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Zip | 50702-6003
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Country | US
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Telephone | 319-235-3172
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Fax | 319-235-3408
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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 | 17284
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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 | 115318
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License Number State | MN
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