Provider Demographics
NPI:1265573992
Name:CASSADY INC
Entity type:Organization
Organization Name:CASSADY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
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:515-244-3221
Mailing Address - Street 1:501 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2702
Mailing Address - Country:US
Mailing Address - Phone:515-244-3221
Mailing Address - Fax:515-244-3222
Practice Address - Street 1:501 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-2702
Practice Address - Country:US
Practice Address - Phone:515-244-3221
Practice Address - Fax:515-244-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 332B00000X
IA5843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0145102Medicaid
2026007OtherPK
IA0145102Medicaid
0334890004Medicare NSC