Provider Demographics
NPI:1790812337
Name:NORGAARD AND WILLIAMS GENERAL PARTERNERSHIP
Entity Type:Organization
Organization Name:NORGAARD AND WILLIAMS GENERAL PARTERNERSHIP
Other - Org Name:BIG CREEK PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:NORGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-984-6554
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50226-0365
Mailing Address - Country:US
Mailing Address - Phone:515-984-6554
Mailing Address - Fax:515-984-6460
Practice Address - Street 1:119 2ND ST.
Practice Address - Street 2:
Practice Address - City:POLK CITY
Practice Address - State:IA
Practice Address - Zip Code:50226-0500
Practice Address - Country:US
Practice Address - Phone:515-984-6554
Practice Address - Fax:515-984-6460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0140483Medicaid