Professional Compounding Center of Iowa, Inc.

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

PROFESSIONAL COMPOUNDING CENTER OF IOWA, INC.

Doing business as

Greenwood Compounding Pharmacy

Practice address

2104 Kimball Ave.
Suite a
Waterloo, IA 50702-5037

Phone

(319) 433-0393

Fax

(319) 234-5627

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Leigh Hughes, PHARMD

Title

Pharmacist-in-Charge/Manager

Phone

(319) 433-0393

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Greenwood Compounding Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1114002284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 KIMBALL AVE.",
            "address_2": "SUITE A.",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025037",
            "telephone_number": "319-433-0393",
            "fax_number": "319-234-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 KIMBALL AVE.",
            "address_2": "SUITE A",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025037",
            "telephone_number": "319-433-0393",
            "fax_number": "319-234-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL COMPOUNDING CENTER OF IOWA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE/MANAGER",
        "authorized_official_telephone_number": "319-433-0393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0489625",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenwood Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.