Organization
VAN DYKE DRUG STORE INC
Active
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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