Provider Demographics
NPI:1336409408
Name:RPH ON THE GO
Entity Type:Organization
Organization Name:RPH ON THE GO
Other - Org Name:RPH ON THE GO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RECRUITER
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SONERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1800-553-7359
Mailing Address - Street 1:2907 WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-9772
Mailing Address - Country:US
Mailing Address - Phone:712-243-3071
Mailing Address - Fax:
Practice Address - Street 1:2907 WHITNEY ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-9772
Practice Address - Country:US
Practice Address - Phone:712-243-3071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty