Provider Demographics
NPI:1801900642
Name:REUTZEL PHARMACY INC
Entity type:Organization
Organization Name:REUTZEL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MULL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:563-505-3528
Mailing Address - Street 1:617 8TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-2117
Mailing Address - Country:US
Mailing Address - Phone:319-364-4181
Mailing Address - Fax:319-363-5448
Practice Address - Street 1:617 8TH AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2117
Practice Address - Country:US
Practice Address - Phone:319-364-4181
Practice Address - Fax:319-365-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1801900642Medicaid
IA07997OtherIOWA BLUE CROSS
IA160OtherPHARMACY LICENSE
IA1601194OtherNABP
IA160OtherPHARMACY LICENSE