Organization
RUSSELL C. SPOTTS
Active
Other names
Ida Grove Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL CLINTON SPOTTS RPH (PHARMACIST)
(712) 364-2734
Entity
Organization
Contact information
Practice address
506 2ND ST, IDA GROVE, IA 51445-1305
(712) 364-2734
(712) 364-3068
Mailing address
506 2ND ST, IDA GROVE, IA 51445-1305
(712) 364-2734
(712) 364-3068
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
768
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0257360
—
IA
01
—
1606360
NABP NUMBER
IA
Enumeration date
03/29/2007
Last updated
08/22/2020
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