Organization
BAX INC
Active
Other names
Fontanelle Drug
Organization subpart
No
Provider details
NPI number
Authorized official
KAYE BAX RPH (PRES)
(641) 745-2008
Entity
Organization
Contact information
Practice address
401 WASHINGTON ST, FONTANELLE, IA 50846-9900
(641) 745-3221
(641) 745-3221
Mailing address
PO BOX 366, 401 WASHINGTON ST, FONTANELLE, IA 50846-0366
(641) 745-3221
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
654
IA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137844
—
IA
01
—
2028010
PK
—
Enumeration date
11/15/2006
Last updated
01/17/2017
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