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NPI Code Detail

MEDICARE: DAVID HENNING RPH

MEDICARE: DAVID HENNING 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
1183500000XPharmacist15723IA

General Provider Information

NPI Number : 1952940108
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID HENNING RPH
Provider Business Mailing Address
First Line : 1019 HIGHLAND PARK CIR
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-9732
Country : US
Telephone Number : 319-331-2795
Fax Number :
Provider Business Practice Location Address
First Line : 1720 WATERFRONT DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52240-4414
Country : US
Telephone Number : 319-354-7121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2020
Last Update Date : 01/04/2020

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