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Provider Information for 1932642600


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GREENWOOD DRUG, INC.

Other Names:  
Doing Business As: 
GREENWOOD COMPLIANCE PHARMACY

Organization Subpart: NO

NPI: 1932642600
Last Updated: 2021-04-23
Certification Date: 2021-04-23

Details

NameValue
NPI1932642600
Enumeration Date2016-11-29
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Mr. ROBERT JOHN GREENWOOD BS Pharmacy
Title: PIC/Owner
Phone: 3192346673
Mailing Address 2104 KIMBALL AVE STE B
WATERLOO, IA 50702-5037
United States

Phone: 319-234-6673 | Fax:319-274-9064
 
Primary Practice Address 2104 KIMBALL AVE
WATERLOO, IA 50702-5037
United States

Phone: 319-234-6673 | Fax:319-226-5898
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDIA1932642600
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy IA1635
Yes 3336L0003X - Pharmacy - Long Term Care Pharmacy