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General NPI Number Information
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NPI Number | 1376659078
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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 | 08/23/2006
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 1141 N BROADWAY
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-1513
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Country | US
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Telephone | 712-322-9019
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Fax | 712-325-9731
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Provider Business Mailing Address
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Address Line | 1141 N BROADWAY
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-1513
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Country | US
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Telephone | 712-322-9019
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Fax | 712-325-9731
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | ANTHONY LEO SCHMID
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Credential | PHARMD
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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 | 972
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License Number State | IA
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