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General NPI Number Information
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NPI Number | 1376516435
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Entity Type | Organization
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Legal Business Name | PHIL'S PHARMACY, LLC
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 401 MAIN ST
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City | REINBECK
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State | IA
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Zip | 50669-1049
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Country | US
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Telephone | 319-788-7445
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Fax | 319-788-7447
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Provider Business Mailing Address
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Address Line | 401 MAIN ST
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City | REINBECK
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State | IA
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Zip | 50669-1049
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Country | US
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Telephone | 319-788-7445
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Fax | 319-788-7447
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. PHIL COLBERT
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Credential | R.PH.
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Telephone | 319-788-7445
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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 | 1182
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License Number State | IA
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