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General NPI Number Information
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NPI Number | 1316390859
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Entity Type | Individual
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Provider Name | ANDREW RIESBERG PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 7501 HICKMAN RD
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City | URBANDALE
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State | IA
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Zip | 50322-4603
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Country | US
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Telephone | 515-270-2623
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Fax |
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Provider Business Mailing Address
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Address Line | 8601 WESTOWN PKWY UNIT 1208
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1655
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Country | US
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Telephone | 319-231-4450
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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 | 22831
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License Number State | IA
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