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General NPI Number Information
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NPI Number | 1922107663
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Entity Type | Organization
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Legal Business Name | MIDLAND PHARMACY, INC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 414 N 18TH ST
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City | CENTERVILLE
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State | IA
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Zip | 52544-1823
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Country | US
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Telephone | 641-437-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RIDER TRAIL PLAZA DR SUITE 300
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City | EARTH CITY
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State | MO
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Zip | 63045-1313
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | V.P. PHARMARCY OPERATIONS
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Name | MARK A MILLER
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Credential |
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Telephone | 800-325-1397
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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 | 404
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | IA
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