Provider Demographics
NPI:1932228988
Name:FREDREGILL, DON T (RPH)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:T
Last Name:FREDREGILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 NATHAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-8725
Mailing Address - Country:US
Mailing Address - Phone:515-955-8125
Mailing Address - Fax:
Practice Address - Street 1:214 S 25TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4314
Practice Address - Country:US
Practice Address - Phone:515-576-3652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist