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General NPI Number Information
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NPI Number | 1447162722
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Entity Type | Individual
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Provider Name | ANTHONY FOUNTOULAKIS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 608 13TH AVE STE 101
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-9909
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Country | US
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Telephone | 712-314-2303
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Fax | 833-702-3437
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Provider Business Mailing Address
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Address Line | 608 13TH AVE STE 101
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-9909
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Country | US
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Telephone | 712-314-2303
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Fax | 833-702-3437
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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 | PST.025848
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | T-102041
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH035855
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 49428
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6878
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License Number State | SD
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18924
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License Number State | NE
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Taxonomy #7
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 76293
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24147
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License Number State | IA
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