Payton Augustine
Individual provider Active NPI Pharmacist · Waterloo, IA
NPI 1134898745 · NPPES record last updated Sep 8, 2021
Key facts
- NPI
- 1134898745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 24146 (IA)
- Practice address
- 1970 Falcon RDG
Waterloo, IA 50701-9343 - Phone
- (319) 290-8857
- NPI assigned
- Sep 8, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24146 | IA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24146 | IA | Yes |
Addresses
Primary practice location
1970 Falcon RDG
Waterloo, IA 50701-9343
Mailing address
1970 Falcon RDG
Waterloo, IA 50701-9343
Phone (319) 290-8857
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2021. 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.