Provider Demographics
NPI:1841897972
Name:PRESCRIPTION SHOPPE, INC.
Entity type:Organization
Organization Name:PRESCRIPTION SHOPPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGHTINGALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-780-9548
Mailing Address - Street 1:604 6TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:DYERSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52040-1540
Mailing Address - Country:US
Mailing Address - Phone:702-780-9548
Mailing Address - Fax:
Practice Address - Street 1:230 MAIN ST
Practice Address - Street 2:
Practice Address - City:MC GREGOR
Practice Address - State:IA
Practice Address - Zip Code:52157-8774
Practice Address - Country:US
Practice Address - Phone:563-873-3781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE PRESCRIPTION SHOPPE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy