Organization
NUDAK VENTURES LLC
Active
Other names
NuCara Pharmacy #20
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WILLIS (ACQUISITIONS MANAGER)
(641) 366-3440
Entity
Organization
Contact information
Practice address
119 N VINE ST, WEST UNION, IA 52175-1346
(563) 422-3151
(563) 422-9333
Mailing address
PO BOX 640, CONRAD, IA 50621-0640
(641) 366-3440
(641) 366-3442
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
219
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0704309
—
IA
01
—
2132876
PK
—
Enumeration date
12/08/2006
Last updated
04/21/2017
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