Provider Demographics
NPI:1558541813
Name:REMEDY DRUG INC
Entity Type:Organization
Organization Name:REMEDY DRUG INC
Other - Org Name:REMEDY DRUG INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:319-330-4328
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:WELLMAN
Mailing Address - State:IA
Mailing Address - Zip Code:52356-0470
Mailing Address - Country:US
Mailing Address - Phone:319-646-4466
Mailing Address - Fax:319-646-4477
Practice Address - Street 1:221 8TH AVE
Practice Address - Street 2:
Practice Address - City:WELLMAN
Practice Address - State:IA
Practice Address - Zip Code:52356
Practice Address - Country:US
Practice Address - Phone:319-646-4466
Practice Address - Fax:319-646-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA13323336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1623215OtherNCPDP PROVIDER IDENTIFICATION NUMBER
IA1558541813Medicaid