Provider Demographics
NPI:1003957960
Name:CASSADY INC
Entity type:Organization
Organization Name:CASSADY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER, PIC
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSADY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:515-285-2474
Mailing Address - Street 1:3300 SW 9TH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-7666
Mailing Address - Country:US
Mailing Address - Phone:515-285-2474
Mailing Address - Fax:515-285-2902
Practice Address - Street 1:3300 SW 9TH ST STE 10
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-7666
Practice Address - Country:US
Practice Address - Phone:515-285-2474
Practice Address - Fax:515-285-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
IA3063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1037135Medicaid
2026840OtherPK
0334890001Medicare NSC
IA1037135Medicaid