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Organization

NUDAK VENTURES LLC

Active
Other names
NuCara Compounding Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
LORI ANN WILLIS (ACQUISITIONS MANAGER)
(641) 366-3440
Entity
Organization

Contact information

Practice address
105 W MAIN ST STE A, OTTUMWA, IA 52501-2542
(641) 683-8168
(515) 684-5407
Mailing address
105 W MAIN ST, OTTUMWA, IA 52501-2542
(641) 683-8168
(515) 684-5407

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0004X
Compounding Pharmacy
Primary
1057
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619595
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
01/02/2007
Last updated
06/12/2019
About Stedi
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  • Eligibility checks
  • EDI platform