# P B R INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Med-Equip Homecare Pharmacy \#3
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235245051
- **Authorized official:** MR. WALLY J. TSCHOPP RPH (OWNER)
- **Authorized official phone:** (712) 728-2165

## Contact information

- **Practice address:** 141 S CENTRAL AVE, HARTLEY, IA 51346-1412
- **Practice address phone:** (712) 728-2165
- **Practice address fax:** (712) 728-2805
- **Mailing address:** PO BOX 28, HARTLEY, IA 51346-0028
- **Mailing address phone:** (712) 728-2165
- **Mailing address fax:** (712) 728-2805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | IA | — |
| 332BC3200X | Customized Equipment (DME) | — | IA | — |
| 3336H0001X | Home Infusion Therapy Pharmacy | 1107 | IA | — |
| 3336H0001X | Home Infusion Therapy Pharmacy | 2613819 | MN | — |
| 3336L0003X | Long Term Care Pharmacy | 1107 | IA | Yes |
| 3336L0003X | Long Term Care Pharmacy | 2613819 | MN | — |

## Other

- **Enumeration date:** 08/22/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0199414 | — | IA |
| 01 | — | 1107 | PHARMACY LICENSE | IA |
| 01 | — | 1620322 | NCPDP | IA |
| 01 | — | 2613819 | PHARMACY LICENSE | MN |