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Organization
GLENWOOD RESOURCE CENTER
Active
Organization
GLENWOOD RESOURCE CENTER
Active
Other names
Glenwood Resource Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ANDERS (SUPERINTENDENT OF FACILITY)
(712) 525-1251
Entity
Organization
Contact information
Practice address
711 S VINE ST, ATTN: PHARMACY, GLENWOOD, IA 51534-1927
(712) 525-1316
(712) 525-1262
Mailing address
711 S VINE ST, ATTN: PHARMACY, GLENWOOD, IA 51534-1927
(712) 525-1316
(712) 525-1262
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
559
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140103
—
IA
01
—
2029593
PK
—
Enumeration date
06/13/2006
Last updated
09/04/2014
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