Organization
P B R INC
Active
Other names
Med-Equip Pharmacy #0
Organization subpart
No
Provider details
NPI number
Authorized official
WALLY J. TSCHOPP RPH (OWNER)
(712) 728-2165
Entity
Organization
Contact information
Practice address
141 S CENTRAL AVE, HARTLEY, IA 51346-1412
(712) 728-2165
(712) 728-2805
Mailing address
PO BOX 28, HARTLEY, IA 51346-0028
(712) 728-2165
(712) 728-2805
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
648
IA
3336C0003X
Community/Retail Pharmacy
648
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0062695
—
IA
01
—
1603895
NCPDP
IA
01
—
648
PHARMACY LICENSE
IA
05
—
797122200
—
MN
05
—
8533350
—
SD
Enumeration date
08/22/2006
Last updated
03/07/2023
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