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General NPI Number Information
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NPI Number | 1609811892
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Entity Type | Organization
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Legal Business Name | RYAN PHARMACY INC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 1600 1ST ST E
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City | INDEPENDENCE
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State | IA
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Zip | 50644-3155
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Country | US
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Telephone | 319-334-7171
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Fax | 319-334-7074
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Provider Business Mailing Address
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Address Line | 1600 1ST ST E
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City | INDEPENDENCE
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State | IA
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Zip | 50644-3155
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Country | US
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Telephone | 319-334-7171
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Fax | 319-334-7074
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Authorized Official
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Title or Position | OWNER
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Name | KERRY RYAN
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Credential |
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Telephone | 319-334-7171
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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 | 705
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License Number State | IA
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