Provider Demographics
NPI:1841836715
Name:LANGRECK, JORDAN CATHERINE (PHARMD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:CATHERINE
Last Name:LANGRECK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:IA
Mailing Address - Zip Code:50622-9546
Mailing Address - Country:US
Mailing Address - Phone:563-203-1073
Mailing Address - Fax:
Practice Address - Street 1:1345 S FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662-3060
Practice Address - Country:US
Practice Address - Phone:319-283-4100
Practice Address - Fax:319-283-5599
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist