Organization
BOOTH PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW SCOTT HUMMEL R. PH. (PHARMACIST)
(712) 551-2374
Entity
Organization
Contact information
Practice address
903 CENTRAL AVE, HAWARDEN, IA 51023-2233
(712) 551-2374
(712) 551-1590
Mailing address
903 CENTRAL AVE, P.O. BOX 233, HAWARDEN, IA 51023-2233
(712) 551-2374
(712) 551-1590
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
454
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0048975
—
IA
Enumeration date
10/24/2006
Last updated
08/22/2020
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