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ALLEN MEMORIAL HOSPITAL NPI 1134127442


NPI Information

NPI: 1134127442
Provider Name: ALLEN MEMORIAL HOSPITAL

Doing Business As: UNITED MED PARK CLINIC PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 16D0721217

Address:
1731 W RIDGEWAY AVE
WATERLOO, IA
ZIP 50701
Phone: (319) 833-5725
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ALLEN MEMORIAL HOSPITAL is a community/retail pharmacy pharmacy in Waterloo, IA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. ALLEN MEMORIAL HOSPITAL NPI is 1134127442. The provider is registered as an organization entity type.
The provider Is Doing Business As United Med Park Clinic Pharmacy.

The provider's business location address is:

1731 W RIDGEWAY AVE
WATERLOO, IA
ZIP 50701-595
Phone: (319) 833-5725
Fax: (319) 833-5729

The provider's authorized official is Laura Gansen .
The authorized official title is Pharmacy Coordinator Pic and has the following contact phone number (319) 833-5725.

The CLIA number assigned to this NPI record is 16D0721217 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/11/2005 and was last updated on 9/13/2007.


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
13336C0003XPharmacyCommunity/Retail Pharmacy1028IOWAYes

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
10175554MEDICAIDIOWA
21015900004MEDICARE NSC
31619115OTHEROTHER ID NUMBER

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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