Organization
GLENWOOD RESOURCE CENTER
Active
Other names
Glenwood Resource Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ANDERS (SUPERINTENDENT OF FACILITY)
(712) 525-1251
Entity
Organization
Contact information
Practice address
711 S VINE ST, ATTN: PHARMACY, GLENWOOD, IA 51534-1927
(712) 525-1316
(712) 525-1262
Mailing address
711 S VINE ST, ATTN: PHARMACY, GLENWOOD, IA 51534-1927
(712) 525-1316
(712) 525-1262
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
559
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140103
—
IA
01
—
2029593
PK
—
Enumeration date
06/13/2006
Last updated
09/04/2014
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