Organization
NUDAK VENTURES, LLC
Active
Other names
NUCARA PHARMACY #10
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WILLIS (DELEGATED OFFICIAL)
(641) 366-3440
Entity
Organization
Contact information
Practice address
621 BROAD ST, STORY CITY, IA 50248-1200
(515) 733-2233
(515) 733-2366
Mailing address
PO BOX 640, CONRAD, IA 50621-0640
(515) 733-2233
(515) 733-2366
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
78
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181230
—
IA
01
—
1609847
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/10/2006
Last updated
05/06/2025
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