Organization
TAYLOR PHARMACY REVOC TRUST
Active
Other names
TAYLOR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON C REED RPH (OWNER PHARMACIST)
(712) 542-3522
Entity
Organization
Contact information
Practice address
122 124 NORTH 16TH ST, CLARINDA, IA 51632-1601
(712) 542-3522
(712) 542-2329
Mailing address
122-124 NORTH 16TH ST, CLARINDA, IA 51632-1601
(712) 542-3522
(712) 542-2329
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
145
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019758000001
—
PA
05
—
0036194
—
IA
05
—
1604277
—
MI
05
—
1604277
—
NE
05
—
1604277
—
TX
05
—
8530830
—
SD
Enumeration date
02/15/2007
Last updated
08/22/2020
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