Organization
DICK PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY MEREDITH WANGERIN R. PH. (PRESIDENT)
(515) 255-7676
Entity
Organization
Contact information
Practice address
3024 FOREST AVE, DES MOINES, IA 50311-2912
(515) 255-7676
Mailing address
3024 FOREST AVE, DES MOINES, IA 50311-2912
(515) 255-7676
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
108
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00701280
—
IA
01
—
1604607
NABP
IA
Enumeration date
07/12/2005
Last updated
08/22/2020
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