United Med Park Clinic Pharmacy

LBN: Allen Memorial Hospital
United Med Park Clinic Pharmacy is an health care organization with primary practice located at 1731 W Ridgeway Ave , Waterloo IA 50701-4595. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Allen Memorial Hospital can be contacted via phone (319) 833-5725, or through Gansen, Laura via phone (319) 833-5725.

Contact Information

Primary practice address
1731 W Ridgeway Ave Waterloo IA 50701-4595
Phone: (319) 833-5725
Fax: (319) 833-5729
Website:
Map and Directions
Authorized official contact:
Name: Gansen, Laura R PH
Phone: (319) 833-5725

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 1028 Iowa

Profile Details

NPI number 1134127442
LBN Legal business name Allen Memorial Hospital
DBA Doing business as United Med Park Clinic Pharmacy
Authorized official Gansen, Laura R PH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 11th, 2005
Last updated Sep 13th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134127442 NPPES
Other 1619115 OTHER ID NUMBER
MEDICAID 0175554 OTHER ID NUMBER

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