Organization
P B R INC
Active
Other names
Med-Equip Homecare Pharmacy #3
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALLY J. TSCHOPP RPH (OWNER)
(712) 728-2165
Entity
Organization
Contact information
Practice address
141 S CENTRAL AVE, HARTLEY, IA 51346-1412
(712) 728-2165
(712) 728-2805
Mailing address
PO BOX 28, HARTLEY, IA 51346-0028
(712) 728-2165
(712) 728-2805
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IA
332BC3200X
Customized Equipment (DME)
—
IA
3336H0001X
Home Infusion Therapy Pharmacy
1107
IA
3336H0001X
Home Infusion Therapy Pharmacy
2613819
MN
3336L0003X
Long Term Care Pharmacy
Primary
1107
IA
3336L0003X
Long Term Care Pharmacy
2613819
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199414
—
IA
01
—
1107
PHARMACY LICENSE
IA
01
—
1620322
NCPDP
IA
01
—
2613819
PHARMACY LICENSE
MN
Enumeration date
08/22/2006
Last updated
03/07/2023
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