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General NPI Number Information
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NPI Number | 1285635854
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Entity Type | Individual
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Provider Name | DOUGLAS J FITZGERALD R.PH
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Gender | Male
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3600 30TH ST PHARMACY DEPT MAIL STOP 119
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City | DES MOINES
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State | IA
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Zip | 50310-5876
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Country | US
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Telephone | 515-699-5999
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Fax |
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Provider Business Mailing Address
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Address Line | 3631 SW 34TH ST
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City | DES MOINES
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State | IA
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Zip | 50321-1937
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Country | US
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Telephone | 515-287-3619
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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 | F-15485
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License Number State | IA
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