Kallenbach Drug Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

1617 Issued in IA

Legal business name

KALLENBACH DRUG INC

Doing business as

Widner Drug

Practice address

111 S Franklin St
Manchester, IA 52057-2132

Phone

(563) 249-5679

NPI assigned

Oct 29, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Kallenbach, PHARMD

Title

Owner/Pharmacist

Phone

(563) 249-5679

Specialties & licenses 1

Addresses

Other names 1

• Widner Drug Doing business as

Tax ID family

Kallenbach Drug Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kallenbach Drug Inc

  dba Widner Drug Store

  • Long Term Care Pharmacy
  • Manchester, IA
  • NPI 1609149749
  NPD tax ID

Locations

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

{
    "created_epoch": "1509235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509235200000",
    "number": "1144732330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CIRCLE DR",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571303",
            "telephone_number": "563-249-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRANKLIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520572132",
            "telephone_number": "563-249-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALLENBACH DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-29",
        "last_updated": "2017-10-29",
        "status": "A",
        "authorized_official_last_name": "KALLENBACH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "563-249-5679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "1617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Widner Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melinda Marie Jackson, ARNP, FNP-BC
• Roxanne Jackson, MPT
• Jackson Jaeger, DPT
• David L James, DC
• JWDR Dialysis, PLLC (Tri State Dialysis)
• Kallenbach Drug Inc (Widner Drug Store)
• Kallenbach Drug Inc (Widner Drug)
• William S. Karkow, M.D.
• Mallory Klein
• Cory Joseph Kluesner, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2017; 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.