National Provider Identifier Database

CLINTON MEDICAL CLINIC PHARMACY INC
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

CLINTON MEDICAL CLINIC PHARMACY INC
221 MAIN AVE
CLINTON, IA52732-2241
Phone: 563-242-1724
Fax: 563-243-8435
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X

* Indicates primary specialty

NPI Profile & details for CLINTON MEDICAL CLINIC PHARMACY INC

NPI Number 1710995758
Legal business name
LBN
CLINTON MEDICAL CLINIC PHARMACY INC
Authorized official GERALD WHEELER - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 08/04/2006
Last updated 06/27/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • IA License #: 75
  • IA Medicaid: 0148676

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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