Organization
NUDAK VENTURES, LLC
Active
Other names
NuCara Pharmacy #3
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WEGMANN (CEO)
(641) 366-3440
Entity
Organization
Contact information
Practice address
209 E SAN MARNAN DR, WATERLOO, IA 50702-5839
(319) 236-8891
(319) 236-9665
Mailing address
209 E SAN MARNAN DR, WATERLOO, IA 50702-5839
(319) 236-8891
(319) 236-9665
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
882
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922231364
BCBS
IA
Enumeration date
09/02/2009
Last updated
05/08/2023
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