1689695637 NPI number — ROCKWELL COLLINS PHARMACY

Table of content: (NPI 1689695637)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689695637 NPI number — ROCKWELL COLLINS PHARMACY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKWELL COLLINS PHARMACY
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:
1689695637
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5070 ROCKWELL DR NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-295-9365
Provider Business Mailing Address Fax Number:
319-373-4414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5070 ROCKWELL DR NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-295-9365
Provider Business Practice Location Address Fax Number:
319-373-4414
Provider Enumeration Date:
07/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HALEY
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
319-295-9365

Provider Taxonomy Codes

  • Taxonomy code: 3336M0003X , with the licence number:  825 , 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: 1617452 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com