Organization
SUN DRUG VILLAGE SQUARE LTD
Active
Organization
SUN DRUG VILLAGE SQUARE LTD
Active
Other names
The Compounding Lab
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE STRAW (PHARMACIST)
(515) 278-5503
Entity
Organization
Contact information
Practice address
6105 MERLE HAY RD, JOHNSTON, IA 50131-1224
(515) 278-5503
Mailing address
PO BOX 288, JOHNSTON, IA 50131-0288
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1034
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619519
NCPDP
—
Enumeration date
05/22/2007
Last updated
06/30/2008
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