Provider Demographics
NPI:1730668146
Name:VILLHAUER, DUSTIN J (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:J
Last Name:VILLHAUER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 E ARMY POST RD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-5942
Mailing Address - Country:US
Mailing Address - Phone:515-287-1022
Mailing Address - Fax:515-285-0627
Practice Address - Street 1:1107 E ARMY POST RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-5942
Practice Address - Country:US
Practice Address - Phone:515-287-1022
Practice Address - Fax:515-285-0627
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist