Organization
NUDAK VENTURES LLC
Active
Other names
NuCara Pharmacy #32
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WILLIS (ACQUISITIONS MANAGER)
(641) 366-3440
Entity
Organization
Contact information
Practice address
2000D S MAIN ST, FAIRFIELD, IA 52556-9572
(641) 469-3001
(641) 469-3036
Mailing address
PO BOX 640, CONRAD, IA 50621-0640
(641) 366-3440
(641) 366-3442
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1468
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111517
—
IA
01
—
2141350
PK
—
Enumeration date
07/25/2013
Last updated
04/24/2017
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