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General NPI Number Information
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NPI Number | 1699867994
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Entity Type | Organization
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Legal Business Name | OSTERHAUS PHARMACY, INC.
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 918 W PLATT ST SUITE 2
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City | MAQUOKETA
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State | IA
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Zip | 52060-2038
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Country | US
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Telephone | 563-652-5611
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Fax | 563-652-6242
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Provider Business Mailing Address
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Address Line | 918 W PLATT ST SUITE 2
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City | MAQUOKETA
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State | IA
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Zip | 52060-2038
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Country | US
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Telephone | 563-652-5611
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Fax | 563-652-6242
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW C OSTERHAUS
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Credential |
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Telephone | 563-652-5611
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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 | 22
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License Number State | IA
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