Provider Demographics
NPI:1144380817
Name:CARROLL APOTHECARY, INC
Entity Type:Organization
Organization Name:CARROLL APOTHECARY, INC
Other - Org Name:HOME CARE MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER, VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEITING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-792-2671
Mailing Address - Street 1:18 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-1928
Mailing Address - Country:US
Mailing Address - Phone:712-263-8016
Mailing Address - Fax:
Practice Address - Street 1:18 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-1928
Practice Address - Country:US
Practice Address - Phone:712-263-8016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMACY ASSOCIATES OF CARROLL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-11
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0739557Medicaid
0144700004Medicare NSC