Organization
MIDLAND PHARMACY, INC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A MILLER (V.P. PHARMARCY OPERATIONS)
(800) 325-1397
Entity
Organization
Contact information
Practice address
414 N 18TH ST, CENTERVILLE, IA 52544-1823
(641) 437-4357
Mailing address
1 RIDER TRAIL PLAZA DR, SUITE 300, EARTH CITY, MO 63045-1313
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
404
IA
3336C0003X
Community/Retail Pharmacy
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1613808
NABP
—
05
—
208058
—
IA
Enumeration date
09/21/2006
Last updated
03/07/2023
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