Organization
DUTCH MILL CORPORATION
Active
Other names
DUTCH MILL CLINIC PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT PLENDER (CO-OWNER)
(712) 737-4844
Entity
Organization
Contact information
Practice address
1000 LINCOLN CIR SE, ORANGE CITY, IA 51041-1836
(712) 737-5347
(712) 737-5348
Mailing address
1000 LINCOLN CIR SE, ORANGE CITY, IA 51041-1836
(712) 737-5347
(712) 737-5348
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1290
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0488445
—
IA
01
—
1622530
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/29/2006
Last updated
10/18/2011
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