Provider Demographics
NPI:1043567050
Name:TOWNCREST PHARMACY CORP
Entity Type:Organization
Organization Name:TOWNCREST PHARMACY CORP
Other - Org Name:SOLON TOWNCREST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DENINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:319-259-7556
Mailing Address - Street 1:2306 MUSCATINE AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6637
Mailing Address - Country:US
Mailing Address - Phone:319-324-2239
Mailing Address - Fax:
Practice Address - Street 1:101 WINDFLOWER LN
Practice Address - Street 2:SUITE 100
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-4709
Practice Address - Country:US
Practice Address - Phone:319-324-2239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0216080001Medicare UPIN