Provider Demographics
NPI:1043307705
Name:C R PHARMACY SERVICE INC
Entity Type:Organization
Organization Name:C R PHARMACY SERVICE INC
Other - Org Name:CAREPRO COMPOUNDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-363-4554
Mailing Address - Street 1:402 10TH ST SE STE 100
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2441
Mailing Address - Country:US
Mailing Address - Phone:319-369-9631
Mailing Address - Fax:317-247-7202
Practice Address - Street 1:402 10TH ST SE STE 100
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2441
Practice Address - Country:US
Practice Address - Phone:319-369-9631
Practice Address - Fax:319-247-7202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA12503336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy