MEDICARE: TOWNCREST COMPOUNDING LLC

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	3336C0004X	Compounding Pharmacy	1318	IA

General Provider Information

NPI Number	:	1063534154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWNCREST COMPOUNDING LLC

Provider Business Mailing Address
First Line	:	2306 MUSCATINE AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6637
Country	:	US
Telephone Number	:	319-337-3526
Fax Number	:	319-337-5271

Provider Business Practice Location Address
First Line	:	901 S 1ST AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-5211
Country	:	US
Telephone Number	:	319-688-4386
Fax Number	:	319-337-5271

Authorized Official
Title or Position	:	COMPOUDING PHARMACIST
Name	:	MR. MICHAEL DEBUBGER
Credential	:	RPH PHD
Telephone Number	:	319-337-3536

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	09/29/2023

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Directions to “TOWNCREST COMPOUNDING LLC ” Practice Location

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