MEDICARE: BETTER HEALTH, 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
1	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IB1239	OTHER		MEDICARE PTAN # (ROSTER BILLER)

Other Identifiers

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

General Provider Information

NPI Number	:	1700942802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETTER HEALTH, INC.

Provider Business Mailing Address
First Line	:	318 E ERIE ST
Second Line	:
City	:	MISSOURI VALLEY
State	:	IA
Zip	:	51555-1619
Country	:	US
Telephone Number	:	712-642-2747
Fax Number	:	712-642-4627

Provider Business Practice Location Address
First Line	:	318 E ERIE ST
Second Line	:
City	:	MISSOURI VALLEY
State	:	IA
Zip	:	51555-1619
Country	:	US
Telephone Number	:	712-642-2747
Fax Number	:	712-642-4627

Authorized Official
Title or Position	:	OWNER-PHARMACIST IN CHARGE
Name	:	LINDA LEE GRIMM
Credential	:	R.PH.
Telephone Number	:	712-642-2747

Provider Enumeration Date	:	12/31/2006
Last Update Date	:	01/28/2009

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Directions to “BETTER HEALTH, INC. ” Practice Location

Language	Start Address	Practice Location

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