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General NPI Number Information
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NPI Number | 1932228988
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Entity Type | Individual
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Provider Name | DON T. FREDREGILL R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 214 S 25TH ST
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City | FORT DODGE
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State | IA
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Zip | 50501-4314
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Country | US
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Telephone | 515-576-3652
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Fax |
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Provider Business Mailing Address
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Address Line | 2026 NATHAN BLVD
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City | FORT DODGE
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State | IA
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Zip | 50501-8725
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Country | US
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Telephone | 515-955-8125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 19297
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License Number State | IA
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