Pharma340 LLC
Pharmacy, Community/Retail Pharmacy in Lake View, IA. Organization (NPI-2).
NPI number1235698564
StatusActive
Last updated in NPPESDec 17, 2024
Details
- NPI
- 1235698564
- Entity type
- Organization (NPI-2)
- Legal business name
- Pharma340 LLC
- Organization subpart
- No
- Enumeration date
- Mar 16, 2019
- Certification date
- Dec 17, 2024
- Last updated
- Dec 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | – | – |
Other names
- Community Pharmacy Of Lake View (Doing Business As)
Practice location
1160 3rd StLake View, IA 51450-7612
Phone 712-665-8555
Mailing address
1321 W Main StLake City, IA 51449-1585
Phone 712-830-5443
Authorized official
Steven Donnelly
President
2104412036
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