# CHARTWELL PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Serviam Pharmacy of Council Bluffs
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154020402
- **Authorized official:** MR. DOUGLAS ROBERT RUSSELL RPH (OWNER / MANAGING PARTNER)
- **Authorized official phone:** (502) 817-8620

## Contact information

- **Practice address:** 608 13TH AVE STE 101, COUNCIL BLUFFS, IA 51501-6401
- **Practice address phone:** (712) 314-2303
- **Practice address fax:** (712) 224-4043
- **Mailing address:** 608 13TH AVE STE 101, COUNCIL BLUFFS, IA 51501-6401
- **Mailing address phone:** (712) 314-2303
- **Mailing address fax:** (712) 224-4043

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/27/2023
- **Last updated:** 02/27/2023