Organization
ONE 2 ONE SAC CITY LLC
Active
Other names
Sac City Drug
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA FOWLER (RPH)
(712) 662-7146
Entity
Organization
Contact information
Practice address
514 W MAIN ST, SAC CITY, IA 50583-1727
(712) 662-7146
(712) 662-3226
Mailing address
PO BOX 367, SAC CITY, IA 50583-0367
(712) 662-7146
(712) 662-3226
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1601
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168141
PK
—
Enumeration date
03/17/2017
Last updated
03/17/2017
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