Organization
BAUDER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK GRAZIANO RPH (OWNER)
(515) 255-1124
Entity
Organization
Contact information
Practice address
3802 INGERSOLL AVE, DES MOINES, IA 50312-3413
(515) 255-1124
Mailing address
3802 INGERSOLL AVE, DES MOINES, IA 50312-3413
(515) 255-1124
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
222
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0037291
—
IA
Enumeration date
11/05/2008
Last updated
11/05/2008
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