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General NPI Number Information
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NPI Number | 1972521862
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Entity Type | Organization
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Legal Business Name | NUDAK VENTURES LLC
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 3600 UNIVERSITY BLVD STE 103
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City | AMES
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State | IA
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Zip | 50010-8674
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Country | US
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Telephone | 515-292-3604
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Fax | 515-292-3645
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | CONRAD
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State | IA
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Zip | 50621-0640
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Country | US
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Telephone | 641-366-3440
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Fax | 641-366-3442
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Authorized Official
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Title or Position | ACQUISITIONS MANAGER
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Name | LORI WILLIS
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Credential |
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Telephone | 641-366-3440
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 1444
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License Number State | IA
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