Provider Demographics
NPI:1922214246
Name:NADAREVIC, DEBORAH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:NADAREVIC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3801 STONEBRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265
Mailing Address - Country:US
Mailing Address - Phone:515-975-1731
Mailing Address - Fax:641-872-2031
Practice Address - Street 1:YOUR NEIGHBORHOOD PHARMACY
Practice Address - Street 2:510 E. JEFFERSON STREET SUITE A
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060
Practice Address - Country:US
Practice Address - Phone:641-872-2030
Practice Address - Fax:641-872-2031
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist