Organization
LIFE RX INC
Active
Other names
Scott Drug Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WALKER (OWNER)
(563) 659-8910
Entity
Organization
Contact information
Practice address
1021 11TH ST, DE WITT, IA 52742-1209
(563) 659-8910
(563) 659-8411
Mailing address
SCOTT'S THRIFTY WHITE DRUG, 629 6TH AVE, DE WITT, IA 52742
(563) 659-5042
(563) 659-5044
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1228
IA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419267
—
IA
05
—
1437470499
—
IA
01
—
2125508
PK
—
Enumeration date
06/14/2010
Last updated
02/28/2020
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