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NPI Code Detail

MEDICARE: MR. JAMES EDWIN LUDDEN R.PH.

MEDICARE: MR. JAMES EDWIN LUDDEN R.PH.
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
11835P1200XPharmacotherapy Pharmacist13503IA

General Provider Information

NPI Number : 1154689560
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES EDWIN LUDDEN R.PH.
Provider Business Mailing Address
First Line : 817 EAST ST
Second Line :
City : GRINNELL
State : IA
Zip : 50112-2128
Country : US
Telephone Number : 641-236-8763
Fax Number :
Provider Business Practice Location Address
First Line : 108 2ND AVE W
Second Line :
City : TOLEDO
State : IA
Zip : 52342-2140
Country : US
Telephone Number : 641-484-6198
Fax Number : 641-484-4642
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2012
Last Update Date : 04/24/2012

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