Organization
MARGRAMON P C
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MASOODE NIKSERESHT (OWNER)
(712) 527-1200
Entity
Organization
Contact information
Practice address
1206 S LOCUST ST, GLENWOOD, IA 51534
(712) 527-1200
(712) 527-1400
Mailing address
1206 S LOCUST ST, GLENWOOD, IA 51534
(712) 527-1200
(712) 527-1400
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1324
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0793281
—
IA
01
—
1623102
NCPDP
IA
Enumeration date
06/06/2007
Last updated
03/07/2023
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