Organization
CC ANDERSON PC
Active
Other names
MEDICAP
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE M ANDERSON RPH (OWNER)
(515) 795-4252
Entity
Organization
Contact information
Practice address
411 ANNEX RD, MADRID, IA 50156-1471
(515) 795-4252
(515) 795-4255
Mailing address
411 ANNEX RD, MADRID, IA 50156-1471
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
274
IA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005817300
—
MD
05
—
0298539
—
IA
05
—
10025316200
—
NE
01
—
1621627
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
200321290A
—
IN
05
—
20056411500
—
MN
05
—
21514
—
ND
05
—
370458100
—
MI
05
—
8530970
—
SD
Enumeration date
06/15/2005
Last updated
03/16/2009
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