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General NPI Number Information
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NPI Number | 1548113905
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Entity Type | Individual
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Provider Name | BENJAMIN JAGOW
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Gender | Male
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 1331 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50309-2901
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Country | US
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Telephone | 262-339-7176
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Fax |
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Provider Business Mailing Address
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Address Line | 14425 BRIARWOOD LN
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City | URBANDALE
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State | IA
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Zip | 50323-2032
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Country | US
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Telephone |
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Fax |
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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 | 23505
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License Number State | IA
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