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General NPI Number Information
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NPI Number | 1811084056
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Entity Type | Organization
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Legal Business Name | GREENWOOD DRUG INC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 2104 KIMBALL AVE
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City | WATERLOO
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State | IA
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Zip | 50702-5037
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Country | US
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Telephone | 319-234-6673
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Fax | 319-226-5898
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Provider Business Mailing Address
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Address Line | 2104 KIMBALL AVE
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City | WATERLOO
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State | IA
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Zip | 50702-5037
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Country | US
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Telephone | 319-234-6673
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Fax | 319-226-5898
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Authorized Official
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Title or Position | PRESIDENT/PIC
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Name | JOSEPH PATRICK GREENWOOD
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Credential | PHARM.D
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Telephone | 319-236-8067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 334
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License Number State | IA
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