Provider Demographics
NPI:1982757068
Name:NORTHWEST IOWA COMPOUNDING INC
Entity Type:Organization
Organization Name:NORTHWEST IOWA COMPOUNDING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRSIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANLIKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:712-852-2727
Mailing Address - Street 1:3204 1ST ST
Mailing Address - Street 2:SUITE L
Mailing Address - City:EMMETSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50536-2515
Mailing Address - Country:US
Mailing Address - Phone:712-852-2727
Mailing Address - Fax:
Practice Address - Street 1:3204 1ST ST
Practice Address - Street 2:SUITE L
Practice Address - City:EMMETSBURG
Practice Address - State:IA
Practice Address - Zip Code:50536-2515
Practice Address - Country:US
Practice Address - Phone:712-852-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA11373336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1620978OtherNCPDP
IA1137OtherPHARMACY #
BN6972081OtherDEA