Organization
LINCOLN HIGHWAY PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY H FLESHNER R.PH. (OWNER-MANAGER)
(712) 792-2402
Entity
Organization
Contact information
Practice address
859 E US HIGHWAY 30, CARROLL, IA 51401-2617
(712) 792-2402
(712) 792-2403
Mailing address
859 E US HIGHWAY 30, CARROLL, IA 51401-2617
(712) 792-2402
(712) 792-2403
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
585
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0285205
—
IA
Enumeration date
10/16/2006
Last updated
03/04/2011
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