1396862660 NPI number — DR. CHRIS JERROD MEYER RPH PHARMD

Table of content: DR. CHRIS JERROD MEYER RPH PHARMD (NPI 1396862660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396862660 NPI number — DR. CHRIS JERROD MEYER RPH PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEYER
Provider First Name:
CHRIS
Provider Middle Name:
JERROD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
RPH PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1396862660
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 WEST 4TH ST. SUITE 3A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST. ANSGAR
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-713-4381
Provider Business Mailing Address Fax Number:
641-713-2386

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 WEST 4TH ST. SUITE 3A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST. ANSGAR
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-713-4381
Provider Business Practice Location Address Fax Number:
641-713-2386
Provider Enumeration Date:
03/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  117341-5 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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