MEDICARE: DR. BRIDGET MARIE RINDERKNECHT PHARM D

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	183500000X	Pharmacist	19876	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19876	OTHER	IA	PHARMACY LICENSE #

General Provider Information

NPI Number	:	1659596914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIDGET MARIE RINDERKNECHT PHARM D

Provider Business Mailing Address
First Line	:	7413 IDLEDALE RD NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-1022
Country	:	US
Telephone Number	:	319-378-3894
Fax Number	:

Provider Business Practice Location Address
First Line	:	5050 EDGEWOOD RD NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52411-6613
Country	:	US
Telephone Number	:	319-294-9193
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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