Provider Demographics
NPI:1265529408
Name:GIRSCH PHARMACIES, INC.
Entity type:Organization
Organization Name:GIRSCH PHARMACIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:GIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:319-234-6673
Mailing Address - Street 1:2104 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5037
Mailing Address - Country:US
Mailing Address - Phone:319-234-6673
Mailing Address - Fax:319-226-5898
Practice Address - Street 1:2027 FALLS AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-2359
Practice Address - Country:US
Practice Address - Phone:319-234-2634
Practice Address - Fax:319-234-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA7753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1602350OtherNCPDP NO.
IA0005736Medicaid
IA0005736Medicaid