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General NPI Number Information
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NPI Number | 1487977195
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Entity Type | Organization
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Legal Business Name | RELIANT CARE PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 4105 WESTCOR CT STE 1
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City | CORALVILLE
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State | IA
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Zip | 52241-2874
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Country | US
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Telephone | 319-545-5100
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Fax | 319-545-5103
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Provider Business Mailing Address
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Address Line | 4105 WESTCOR CT STE 1
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City | CORALVILLE
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State | IA
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Zip | 52241-2874
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Country | US
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Telephone | 319-545-5100
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Fax | 319-545-5103
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | DEVIN R RUJAWITZ
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Credential |
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Telephone | 314-597-1809
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 1373
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License Number State | IA
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