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General NPI Number Information
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NPI Number | 1932642600
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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 | 11/29/2016
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Last Update Date | 04/23/2021
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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 STE B
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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 | 319-274-9064
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Authorized Official
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Title or Position | PIC/OWNER
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Name | MR. ROBERT JOHN GREENWOOD
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Credential | BS PHARMACY
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Telephone | 319-234-6673
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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 | 1635
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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