Provider Demographics
NPI:1407836778
Name:WESTER DRUG, INC.
Entity Type:Organization
Organization Name:WESTER DRUG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CRC, CPHT
Authorized Official - Phone:563-732-5238
Mailing Address - Street 1:315 EAST SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761
Mailing Address - Country:US
Mailing Address - Phone:563-263-7044
Mailing Address - Fax:563-263-5941
Practice Address - Street 1:315 EAST SECOND STREET
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761
Practice Address - Country:US
Practice Address - Phone:563-263-7044
Practice Address - Fax:563-263-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BX2000X
IA399332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0035071Medicaid
0153290001Medicare NSC
IA0153290001Medicare ID - Type Unspecified