=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588892764
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSEY JUNE BOHR PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2009
-----------------------------------------------------
Last Update Date | 07/30/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 701 10TH ST SE
-----------------------------------------------------
City | CEDAR RAPIDS
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52403-1251
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-398-6062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 367 S STEWART ST
-----------------------------------------------------
City | NORTH LIBERTY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52317-9602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-380-2191
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 20990
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------