Organization
EAGLE GROVE PHARMACY INC
Active
Organization
EAGLE GROVE PHARMACY INC
Active
Other names
EAGLE PHARMACY, Wagner Drug- Eagle Grove
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW J WAGNER PHARMD (PHARMACIST IN CHARGE)
(515) 448-3814
Entity
Organization
Contact information
Practice address
311 W BROADWAY ST, EAGLE GROVE, IA 50533-1711
(515) 448-3814
(515) 448-5429
Mailing address
311 W BROADWAY ST, EAGLE GROVE, IA 50533-1711
(515) 448-3814
(515) 448-5429
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
829
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0196840
—
IA
01
—
1614052
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/22/2006
Last updated
10/06/2025
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