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NPI Code Detail

MEDICARE: MR. DAVID MARK KALLSEN RPH

MEDICARE: MR. DAVID MARK KALLSEN RPH
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
1183500000XPharmacist17011IA

General Provider Information

NPI Number : 1336795178
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID MARK KALLSEN RPH
Provider Business Mailing Address
First Line : 919 HIGHWAY 1 W
Second Line :
City : IOWA CITY
State : IA
Zip : 52246-4225
Country : US
Telephone Number : 319-337-8862
Fax Number : 319-688-9520
Provider Business Practice Location Address
First Line : 919 HIGHWAY 1 W
Second Line :
City : IOWA CITY
State : IA
Zip : 52246-4225
Country : US
Telephone Number : 319-337-8862
Fax Number : 319-688-9520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2019
Last Update Date : 08/16/2019

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Directions to “ MR. DAVID MARK KALLSEN RPH” Practice Location

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