Organization
KALLENBACH DRUG INC
Active
Other names
WIDNER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN KALLENBACH PHARM D (OWNER-PHARMACIST IN CHARGE)
(563) 927-4463
Entity
Organization
Contact information
Practice address
111 S FRANKLIN ST, MANCHESTER, IA 52057
(563) 927-4463
(563) 927-4110
Mailing address
PO BOX 99, MANCHESTER, IA 52057-0099
(563) 927-4463
(563) 927-4110
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
188
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0093351
—
IA
05
—
1841212966
—
IA
01
—
2025946
PK
—
Enumeration date
07/25/2006
Last updated
05/16/2018
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