Organization
MCROCK INC
Active
Other names
Polk City Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROCKFORD ANDERSON (OWNER, SECRETARY, AO)
(515) 289-4008
Entity
Organization
Contact information
Practice address
419 W BRIDGE RD, POLK CITY, IA 50226-2219
(515) 984-6554
(515) 724-7095
Mailing address
PO BOX 365, POLK CITY, IA 50226-0365
(515) 984-6554
(515) 724-7095
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
384
IA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881949782
—
IA
01
—
2136378
PK
—
Enumeration date
07/17/2012
Last updated
01/20/2016
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