Zach Wagner

Individual provider Active NPI Pharmacotherapy Pharmacist · Moville, IA

NPI 1306495049 · NPPES record last updated Sep 5, 2019

Key facts

NPI
1306495049
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacotherapy Pharmacist 1835P1200X
License
6509 (IA)
Practice address
528 S 3Rd St
Moville, IA 51039-2009
Phone
(712) 873-3401
NPI assigned
Sep 5, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Past
since Sep 8, 2019
Accepting new patients
Sanford Health Network Past
since Sep 8, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 6509 IA Yes

Addresses

Primary practice location

528 S 3Rd St
Moville, IA 51039-2009

Mailing address

528 S 3Rd St
Moville, IA 51039-2009
Phone (712) 873-3401

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Moville

Other providers in Moville, IA

All providers in Moville, IA · Pharmacotherapy Pharmacist in Iowa

Sources for this page

Verify at the official NPI Registry.