Carl Victor Chalstrom, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

C16897 Issued in IA

Practice address

1791 Highway 64 E
Anamosa, IA 52205-2112

Phone

(319) 462-3306

Fax

(319) 462-6065

NPI assigned

Feb 22, 2007

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1295860260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 HIGHWAY 64 E",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522052112",
            "telephone_number": "319-462-3306",
            "fax_number": "319-462-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 HIGHWAY 64 E",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522052112",
            "telephone_number": "319-462-3306",
            "fax_number": "319-462-6065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Anamosa",
            "state": "IA",
            "postal_code": "522051142",
            "country_code": "US",
            "telephone_number": "319-462-4421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALSTROM",
        "first_name": "CARL",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "C16897",
            "primary": true
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "IA",
            "license": "16897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "C16897",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cynthia Lea Clough, NCC LMHC
• Brenda Deal, MS, TLMHC
• Debra K. Oldham DDS PC (Anamosa Dental Assoc. PC)
• Misti Deutschle, PMH
• Thomas J Devaney, PHARMACIST

• Pharmacist in Anamosa, IA
• Providers in Anamosa, IA by specialty
• Pharmacist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.