Provider Demographics
NPI:1093441990
Name:LEWIS, DARCI (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:DARCI
Middle Name:
Last Name:LEWIS
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 1:202 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-1929
Mailing Address - Country:US
Mailing Address - Phone:515-408-8348
Mailing Address - Fax:
Practice Address - Street 1:500 S FREMONT ST
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-1508
Practice Address - Country:US
Practice Address - Phone:712-246-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist