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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