Jonathan Kallenbach, PHARMD
Individual provider Active NPI Pharmacist · Anamosa, IA
NPI 1013784701 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1013784701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 21239 (IA)
- Practice address
- 303 W Main St
Anamosa, IA 52205-1190 - Phone
- (563) 875-7455
- NPI assigned
- Dec 4, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21239 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prescription Shoppe Inc | Current |
Accepting new patients | |
| Prescription Shoppe Inc | Current |
Accepting new patients |
Locations
303 W Main St
Anamosa, IA 52205
Phone (319) 462-3306
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21239 | IA | Yes |
Addresses
Primary practice location
303 W Main St
Anamosa, IA 52205-1190
Mailing address
303 W Main St
Anamosa, IA 52205-1190
Phone (319) 462-3306
Other providers in Anamosa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.