Provider Demographics
NPI:1336166214
Name:DRILLING MORNINGSIDE PHARMACY INC
Entity Type:Organization
Organization Name:DRILLING MORNINGSIDE PHARMACY INC
Other - Org Name:DRILLING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DRILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-276-4621
Mailing Address - Street 1:4010 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-2447
Mailing Address - Country:US
Mailing Address - Phone:712-276-4621
Mailing Address - Fax:712-274-1293
Practice Address - Street 1:4010 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-2447
Practice Address - Country:US
Practice Address - Phone:712-276-4621
Practice Address - Fax:712-274-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
IA673336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2026012OtherPK
IA0292342Medicaid
IA1336166214Medicaid
NE1336166214Medicaid
IA0292342Medicaid
IA0292342Medicaid
NE1336166214Medicaid