Provider Demographics
NPI:1073666202
Name:UNCO CORP
Entity Type:Organization
Organization Name:UNCO CORP
Other - Org Name:THOMPSON DEAN DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-252-2761
Mailing Address - Street 1:911 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51103-5336
Mailing Address - Country:US
Mailing Address - Phone:712-252-2761
Mailing Address - Fax:712-258-0549
Practice Address - Street 1:911 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51103-5336
Practice Address - Country:US
Practice Address - Phone:712-252-2761
Practice Address - Fax:712-258-0549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10024974200Medicaid
IA0076687Medicaid
SD8531000Medicaid
SD8531000Medicaid