Organization
NUDAK VENTURES, LLC
Active
Other names
NuCara Pharmacy #30
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ANN WILLIS (ACQUISITIONS MANAGER)
(641) 366-3440
Entity
Organization
Contact information
Practice address
107 N MAIN ST, LENOX, IA 50851-1237
(641) 333-2260
(641) 333-2506
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
1454
IA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212367
—
IA
01
—
2139975
PK
—
Enumeration date
07/09/2006
Last updated
04/21/2017
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