Organization
COLLEGE HILL DRUG CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM JOHN TAIBER RPH (PHARMACIST)
(319) 352-3120
Entity
Organization
Contact information
Practice address
110 10TH ST SW, WAVERLY, IA 50677-2924
(319) 352-3120
(319) 352-5720
Mailing address
110 10TH ST SW, P O BOX 785, WAVERLY, IA 50677-2924
(319) 352-3120
(319) 352-5720
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
80
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006676
—
IA
01
—
00667
BLUE CROSS/BLUE SHIELD
IA
Enumeration date
09/13/2005
Last updated
08/22/2020
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