Provider Demographics
NPI:1982471280
Name:PERKINS, DAVID P (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:PERKINS
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 1:27 WESTLAKE VLG
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-8275
Mailing Address - Country:US
Mailing Address - Phone:712-355-1080
Mailing Address - Fax:
Practice Address - Street 1:601 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:IA
Practice Address - Zip Code:51560
Practice Address - Country:US
Practice Address - Phone:712-482-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist