Individual
GREGORY JAMES JOHANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
2929 WESTOWN PKWY STE 100, WEST DES MOINES, IA 50266-1319
(515) 440-1270
Mailing address
2929 WESTOWN PKWY STE 100, WEST DES MOINES, IA 50266-1319
(515) 440-1270
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14774
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14774
IOWA PHARMACIST LICENCE
IA
Enumeration date
12/07/2017
Last updated
12/07/2017
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