Organization
ST ANTHONY WESTSIDE PHARMACY
Active
Other names
Westside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY RIEDMANN (CEO)
(712) 792-8231
Entity
Organization
Contact information
Practice address
235 HIGHWAY 30, WESTSIDE, IA 51467
(712) 663-4373
(712) 663-4370
Mailing address
311 S CLARK ST, CARROLL, IA 51401-3038
(712) 792-3581
(712) 792-2124
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
1067
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0189316
—
IA
Enumeration date
11/16/2006
Last updated
08/22/2020
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