Provider Demographics
NPI:1679103386
Name:TASLER, MARY KATHERINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:TASLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KATHERINE
Other - Last Name:LANGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:823 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-1345
Mailing Address - Country:US
Mailing Address - Phone:515-832-4025
Mailing Address - Fax:515-832-4083
Practice Address - Street 1:823 2ND ST
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-1345
Practice Address - Country:US
Practice Address - Phone:515-832-4025
Practice Address - Fax:515-832-4083
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist