Provider Demographics
NPI:1659967578
Name:TOTAL DOSE CENTERVILLE, LLC
Entity Type:Organization
Organization Name:TOTAL DOSE CENTERVILLE, LLC
Other - Org Name:OWL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-562-1800
Mailing Address - Street 1:14101 N EASTERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5860
Mailing Address - Country:US
Mailing Address - Phone:405-562-1800
Mailing Address - Fax:405-562-1880
Practice Address - Street 1:213 N 13TH ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1707
Practice Address - Country:US
Practice Address - Phone:641-437-7200
Practice Address - Fax:641-437-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy