Organization
RELIANT CARE PHARMACY SERVICES LLC
Active
Other names
Trio Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIN R RUJAWITZ (BILLING MANAGER)
(314) 597-1809
Entity
Organization
Contact information
Practice address
4105 WESTCOR CT STE 1, CORALVILLE, IA 52241-2874
(319) 545-5100
(319) 545-5103
Mailing address
4105 WESTCOR CT STE 1, CORALVILLE, IA 52241-2874
(319) 545-5100
(319) 545-5103
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
1373
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102901
—
IA
05
—
100258954
—
NE
01
—
2124590
PK
—
Enumeration date
03/09/2010
Last updated
12/15/2022
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