Provider Demographics
NPI:1730288622
Name:MAIER FAMILY PHARMACY PC
Entity Type:Organization
Organization Name:MAIER FAMILY PHARMACY PC
Other - Org Name:WESTERN IOWA COMPOUNDING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:712-881-1033
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:IA
Mailing Address - Zip Code:51034-0067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:409 MAIN ST
Practice Address - Street 2:STE A
Practice Address - City:MAPLETON
Practice Address - State:IA
Practice Address - Zip Code:51034
Practice Address - Country:US
Practice Address - Phone:712-882-1034
Practice Address - Fax:712-882-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1174333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1621502OtherOTHER ID NUMBER-COMMERCIAL NUMBER