Organization
CAMANCHE DRUG STORE
Active
Other names
Camanche Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BARK (PRESIDENT)
(563) 321-6324
Entity
Organization
Contact information
Practice address
818 7TH AVE, CAMANCHE, IA 52730-1811
(563) 259-8361
(563) 259-9208
Mailing address
PO BOX 225, CAMANCHE, IA 52730-0225
(563) 259-8361
(563) 259-9208
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
140
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1624027
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/21/2011
Last updated
01/13/2012
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