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NPI Code Detail

MEDICARE: KINNE FAMILY PHARMACY INC

MEDICARE: KINNE FAMILY PHARMACY 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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336L0003XLong Term Care Pharmacy
43336C0003XCommunity/Retail Pharmacy1473IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12142371OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396782991
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINNE FAMILY PHARMACY INC
Provider Business Mailing Address
First Line : 120 S STORY ST
Second Line : SUITE C
City : BOONE
State : IA
Zip : 50036-4739
Country : US
Telephone Number : 515-432-3460
Fax Number : 515-432-7169
Provider Business Practice Location Address
First Line : 120 S STORY ST
Second Line :
City : BOONE
State : IA
Zip : 50036-4739
Country : US
Telephone Number : 515-432-3460
Fax Number : 515-432-7169
Authorized Official
Title or Position : PIC OWNER
Name : WENDY ANN KINNE
Credential : PHARMD
Telephone Number : 515-432-3460
Provider Enumeration Date : 06/01/2006
Last Update Date : 04/21/2023

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1356390686 — IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
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1609920602 — MRS. WENDY ANN KINNE PHARMD
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1063722445 — DANIELLE MARIE MILBRANDT PHARMD
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Directions to “KINNE FAMILY PHARMACY INC ” Practice Location

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