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General NPI Number Information
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NPI Number | 1801881123
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Entity Type | Organization
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Legal Business Name | COLLEGE HILL DRUG CO.
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 110 10TH ST SW
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City | WAVERLY
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State | IA
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Zip | 50677-2924
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Country | US
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Telephone | 319-352-3120
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Fax | 319-352-5720
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Provider Business Mailing Address
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Address Line | 110 10TH ST SW P O BOX 785
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City | WAVERLY
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State | IA
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Zip | 50677-2924
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Country | US
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Telephone | 319-352-3120
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Fax | 319-352-5720
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. TOM JOHN TAIBER
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Credential | RPH
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Telephone | 319-352-3120
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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 | 80
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License Number State | IA
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