Provider Demographics
NPI:1003422429
Name:EID, KARA RENEE (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:RENEE
Last Name:EID
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 343RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEVER
Mailing Address - State:IA
Mailing Address - Zip Code:52658-9564
Mailing Address - Country:US
Mailing Address - Phone:319-470-8483
Mailing Address - Fax:
Practice Address - Street 1:2639 AVENUE L
Practice Address - Street 2:
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-3840
Practice Address - Country:US
Practice Address - Phone:319-372-8794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA239831835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist