Organization
CARROLL APOTHECARY, INC
Active
Other names
Carroll Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON K LEITING (VICE-PRESIDENT / BUSINESS MANAGER)
(712) 792-2671
Entity
Organization
Contact information
Practice address
425 HIGHWAY 30 WEST, SUITE 140, CARROLL, IA 51401-0157
(712) 792-2671
(712) 792-3601
Mailing address
PO BOX 157, CARROLL, IA 51401-0157
(712) 792-2671
(712) 792-3601
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
IA
333600000X
Pharmacy
Primary
357
IA
3336H0001X
Home Infusion Therapy Pharmacy
357
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101806
—
IA
01
—
1605205
NABP
IA
01
—
IB1631
LOCAL PART B
IA
Enumeration date
08/23/2005
Last updated
06/19/2012
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