National Provider Identifier Database

STATE UNIVERSITY OF IOWA
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

STATE UNIVERSITY OF IOWA
3056 RIVER CROSSING COURT
STE A
RIVERSIDE, IA52327
Phone: 319-467-8383
Fax: 319-467-8378
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for STATE UNIVERSITY OF IOWA

NPI Number 1174845101
Legal business name
LBN
STATE UNIVERSITY OF IOWA
Authorized official JAY JACKSON - (VICE PRESIDENT FOR MEDICAL AFFAIRS)
Entity Organization
Organization subpart No
Enumeration date 02/18/2010
Last updated 09/06/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • IA License #: 1370
  • IA License #: 18469
  • IA Medicaid: 0402616
  • Other: 1623772 NCPDP PROVIDER IDENTIFICATION NUMBER

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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