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General NPI Number Information
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NPI Number | 1750447470
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Entity Type | Organization
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Legal Business Name | SUMNER PHARMACY, INC.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 100 E 1ST ST
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City | SUMNER
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State | IA
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Zip | 50674-1430
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Country | US
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Telephone | 563-578-5142
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Fax | 563-578-5190
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Provider Business Mailing Address
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Address Line | 100 E 1ST ST PO BOX 205
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City | SUMNER
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State | IA
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Zip | 50674-1430
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Country | US
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Telephone | 563-578-5142
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Fax | 563-578-5190
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES ROBERT KENNEDY
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Credential | RPH
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Telephone | 563-578-5142
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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 | 43
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License Number State | IA
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