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General NPI Number Information
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NPI Number | 1528137015
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Entity Type | Organization
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Legal Business Name | GREENVILLE PHARMACY INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 2701 CORRECTIONVILLE RD
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City | SIOUX CITY
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State | IA
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Zip | 51105-3627
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Country | US
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Telephone | 712-258-0113
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Fax | 712-258-0351
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Provider Business Mailing Address
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Address Line | 2701 CORRECTIONVILLE RD
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City | SIOUX CITY
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State | IA
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Zip | 51105-3627
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Country | US
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Telephone | 712-258-0113
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Fax | 712-258-0351
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Authorized Official
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Title or Position | VP
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Name | MR. ROBERT P REHAL
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Credential | PHARMACIST
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Telephone | 712-258-0113
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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 | 667
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License Number State | IA
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