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PROFESSIONAL COMPOUNDING CENTER OF IOWA INC. NPI 1114002284


NPI Information

NPI: 1114002284
Provider Name: PROFESSIONAL COMPOUNDING CENTER OF IOWA, INC.

Doing Business As: GREENWOOD COMPOUNDING PHARMACY

Classification: Pharmacy - 3336C0004X
Entity Type: Organization

Specialization: Compounding Pharmacy

Address:
2104 KIMBALL AVE.
SUITE A
WATERLOO, IA
ZIP 50702
Phone: (319) 433-0393
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PROFESSIONAL COMPOUNDING CENTER OF IOWA, INC. is a compounding pharmacy pharmacy in Waterloo, IA. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. PROFESSIONAL COMPOUNDING CENTER OF IOWA, INC. NPI is 1114002284. The provider is registered as an organization entity type.
The provider Is Doing Business As Greenwood Compounding Pharmacy.

The provider's business location address is:

2104 KIMBALL AVE.
SUITE A
WATERLOO, IA
ZIP 50702-037
Phone: (319) 433-0393
Fax: (319) 234-5627

The provider's authorized official is Jennifer Leigh Hughes .
The authorized official title is Pharmacist-in-charge/manager and has the following contact phone number (319) 433-0393.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 8/14/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0004XPharmacyCompounding PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10489625MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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