Provider Demographics
NPI:1265463400
Name:DGS-ACQUISITIONS LLC
Entity Type:Organization
Organization Name:DGS-ACQUISITIONS LLC
Other - Org Name:PRICE CHOPPER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:515-255-8642
Mailing Address - Street 1:4343 MERLE HAY RD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1411
Mailing Address - Country:US
Mailing Address - Phone:515-276-4845
Mailing Address - Fax:515-331-3163
Practice Address - Street 1:4343 MERLE HAY RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1411
Practice Address - Country:US
Practice Address - Phone:515-276-4845
Practice Address - Fax:515-331-3163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1265463400OtherMEDICARE PTAN
IA1265463400Medicaid
I20027OtherMEDICARE FLU ROSTER
IA0098871Medicaid
1607906OtherNCPDP
IA1265463400Medicaid