Provider Demographics
NPI:1609371178
Name:DRILLING MORNINGSIDE PHARMACY INC
Entity Type:Organization
Organization Name:DRILLING MORNINGSIDE PHARMACY INC
Other - Org Name:DRILLING MORNINGSIDE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PHARMACIST IN CHRGE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DRILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-276-4621
Mailing Address - Street 1:4010 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106
Mailing Address - Country:US
Mailing Address - Phone:712-276-4621
Mailing Address - Fax:712-274-1293
Practice Address - Street 1:4010 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-2447
Practice Address - Country:US
Practice Address - Phone:712-276-4621
Practice Address - Fax:712-274-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IA673336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2176601OtherPK