Provider Demographics
NPI:1003455593
Name:FALK, CRAIG QUINN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:QUINN
Last Name:FALK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EARLY BIRD DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52537-1168
Mailing Address - Country:US
Mailing Address - Phone:641-208-0959
Mailing Address - Fax:
Practice Address - Street 1:1140 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2017
Practice Address - Country:US
Practice Address - Phone:641-684-5467
Practice Address - Fax:641-683-8364
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist