Camanche Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

140 Issued in IA

Legal business name

CAMANCHE PHARMACY INC

Practice address

818 7TH Ave
Camanche, IA 52730

Phone

(563) 259-8361

Fax

(563) 259-9208

NPI assigned

Dec 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert E Richeson, RPH

Title

Owner Manager

Phone

(563) 259-8361

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083782569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 7TH AVE",
            "city": "CAMANCHE",
            "state": "IA",
            "postal_code": "52730",
            "telephone_number": "563-259-8361",
            "fax_number": "563-259-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 7TH AVE",
            "city": "CAMANCHE",
            "state": "IA",
            "postal_code": "52730",
            "telephone_number": "563-259-8361",
            "fax_number": "563-259-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMANCHE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHESON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "563-259-8361",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1604873",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011692",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• James C Boysen, DC, PC
• Gary Paul Low, DDS

• Pharmacy in Camanche, IA
• Providers in Camanche, IA by specialty
• Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.