Organization
STATE UNIVERSITY OF IOWA
Active
Other names
UI Healthcare-River Crossing Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAY BROOKS JACKSON MD (VICE PRESIDENT FOR MEDICAL AFFAIRS)
(319) 335-8064
Entity
Organization
Contact information
Practice address
3056 RIVER CROSSING COURT, STE A, RIVERSIDE, IA 52327
(319) 467-8383
(319) 467-8378
Mailing address
3056 RIVER CROSSING COURT, STE A, RIVERSIDE, IA 52327-4724
(319) 467-8383
(319) 467-8378
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
18469
IA
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
1370
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0402616
—
IA
01
—
1623772
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/18/2010
Last updated
09/06/2018
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