Provider Demographics
NPI:1881211753
Name:WEBER, DENNIS LEE III (PHARM D)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:LEE
Last Name:WEBER
Suffix:III
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:PRIMGHAR
Mailing Address - State:IA
Mailing Address - Zip Code:51245-1128
Mailing Address - Country:US
Mailing Address - Phone:712-630-1412
Mailing Address - Fax:
Practice Address - Street 1:610 PARK ST
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-1202
Practice Address - Country:US
Practice Address - Phone:712-324-4331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6750183500000X
IA23845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist