Provider Demographics
NPI:1922045343
Name:PANOSH, JULIE A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:PANOSH
Suffix:
Gender:F
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 1:20507 263RD ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-8585
Mailing Address - Country:US
Mailing Address - Phone:563-922-9085
Mailing Address - Fax:
Practice Address - Street 1:201 1ST AVE E
Practice Address - Street 2:
Practice Address - City:DYERSVILLE
Practice Address - State:IA
Practice Address - Zip Code:52040-1202
Practice Address - Country:US
Practice Address - Phone:563-875-7624
Practice Address - Fax:563-875-8259
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist