Provider Demographics
NPI:1508985581
Name:COURTNAGE DRUG INC
Entity Type:Organization
Organization Name:COURTNAGE DRUG INC
Other - Org Name:STRAWBERRY POINT DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-933-4762
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY POINT
Mailing Address - State:IA
Mailing Address - Zip Code:52076-0036
Mailing Address - Country:US
Mailing Address - Phone:563-933-4762
Mailing Address - Fax:
Practice Address - Street 1:104 WEST MISSION
Practice Address - Street 2:
Practice Address - City:STRAWBERRY POINT
Practice Address - State:IA
Practice Address - Zip Code:52076
Practice Address - Country:US
Practice Address - Phone:563-933-4762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAAC4041911OtherDEA
IA0281500001Medicare ID - Type Unspecified