MEDICARE: PHARMACY ASSOCIATES OF CARROLL,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	353	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013900018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY ASSOCIATES OF CARROLL,INC

Provider Business Mailing Address
First Line	:	405 S CLARK ST STE 150
Second Line	:	PO BOX 157
City	:	CARROLL
State	:	IA
Zip	:	51401-3066
Country	:	US
Telephone Number	:	712-792-3212
Fax Number	:	712-792-0160

Provider Business Practice Location Address
First Line	:	405 S CLARK ST
Second Line	:	SUITE 150
City	:	CARROLL
State	:	IA
Zip	:	51401-3065
Country	:	US
Telephone Number	:	712-792-3212
Fax Number	:	712-792-0160

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	ANDREW SEGEBART
Credential	:	PHARM D.
Telephone Number	:	712-792-3212

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	09/13/2010

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