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General NPI Number Information
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NPI Number | 1417923061
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Entity Type | Organization
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Legal Business Name | GUTTENBERG PHARMACY INC
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 807 S HIGHWAY 52
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City | GUTTENBERG
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State | IA
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Zip | 52052-0280
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Country | US
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Telephone | 563-252-1172
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Fax | 563-252-3724
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Provider Business Mailing Address
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Address Line | 807 S HIGHWAY 52 PO BOX 280
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City | GUTTENBERG
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State | IA
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Zip | 52052-0280
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Country | US
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Telephone | 563-252-1172
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Fax | 563-252-3724
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIEL J SHANNON
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Credential | RPH
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Telephone | 563-252-1172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5
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License Number State | IA
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