Organization
NUDAK VENTURES LLC
Active
Other names
NuCara Pharmacy #1
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ANN WILLIS (ACQUISITIONS MANAGER)
(641) 366-3440
Entity
Organization
Contact information
Practice address
1900 JAMES ST STE 10B, CORALVILLE, IA 52241-1895
(319) 354-6006
(319) 354-6050
Mailing address
PO BOX 640, CONRAD, IA 50621-0640
(641) 366-3440
(641) 366-3442
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1091
IA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136152
PK
—
Enumeration date
08/14/2006
Last updated
03/24/2022
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