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General NPI Number Information
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NPI Number | 1982231734
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Entity Type | Individual
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Provider Name | GARIMA GUPTA
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Gender | Female
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 3201 MANAWA CENTRE DR
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-7674
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Country | US
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Telephone | 712-366-1315
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Fax |
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Provider Business Mailing Address
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Address Line | 3904 S 181ST ST
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City | OMAHA
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State | NE
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Zip | 68130-4206
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Country | US
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Telephone | 402-612-7246
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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 | 14068
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22394
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License Number State | IA
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