Organization
VAN DYKE DRUG STORE INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HEIDEBRINK RPH (PHARMACIST)
(641) 673-8486
Entity
Organization
Contact information
Practice address
504 A AVE W, OSKALOOSA, IA 52577-2708
(641) 673-8486
(641) 673-8698
Mailing address
504 A AVE W, OSKALOOSA, IA 52577-2708
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
401
IA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126003
—
IA
01
—
1608085
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
03/07/2023
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