Organization
P.B.R., INC.
Active
Other names
Med-Equip Pharmacy #7
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALLY J. TSCHOPP RPH (PRESIDENT)
(712) 728-2165
Entity
Organization
Contact information
Practice address
1310 18TH ST, SUITE B, SPIRIT LAKE, IA 51360-1150
(712) 336-0318
(712) 336-5742
Mailing address
1310 18TH ST, SUITE B, SPIRIT LAKE, IA 51360-1150
(712) 336-0318
(712) 336-5742
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
1183
IA
3336C0003X
Community/Retail Pharmacy
1183
IA
3336L0003X
Long Term Care Pharmacy
1183
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0285965
—
IA
01
—
1183
PHARMACY LICENSE
IA
01
—
1621285
NCPDP
IA
Enumeration date
08/22/2006
Last updated
03/07/2023
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