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NPI Code Detail

MEDICARE: JEFFREY STEVEN HARTZLER RPH

MEDICARE: JEFFREY STEVEN HARTZLER 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
1183500000XPharmacist15281IA

General Provider Information

NPI Number : 1568081297
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY STEVEN HARTZLER RPH
Provider Business Mailing Address
First Line : 4715 MONTCLAIR DR NW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52405-2825
Country : US
Telephone Number : 319-560-7312
Fax Number :
Provider Business Practice Location Address
First Line : 4825 JOHNSON AVE NW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52405-4207
Country : US
Telephone Number : 319-396-7419
Fax Number : 319-396-5916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2020
Last Update Date : 04/13/2020

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