1033435433 NPI number — RASHID PHARMACY PLC

Table of content: (NPI 1033435433)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033435433 NPI number — RASHID PHARMACY PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RASHID PHARMACY PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033435433
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2404 AVENUE L
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MADISON
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52627-3933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-372-2300
Provider Business Mailing Address Fax Number:
319-372-4418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2402 AVENUE L
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT MADISON
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52627-3933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-376-2358
Provider Business Practice Location Address Fax Number:
319-372-4418
Provider Enumeration Date:
04/12/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DINWIDDIE
Authorized Official First Name:
SUE
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTRACTS
Authorized Official Telephone Number:
319-372-2300

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  054.4017864 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X , with the licence number: 2012029119 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: 1129 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 54.017864 . This is a "STATE OF IL LICENSE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 2012029119 . This is a "LICENSE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 2124396 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0205979 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54.017864 . This is a "LICENSE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1129 . This is a "IOWA BOARD OF PHARMACY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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