Basic Information
| Provider Information | |||||||||
| NPI: | 1346376332 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TSHC PHARMACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2260 THIELEN STUDENT HEALTH CENTER | ||||||||
| Address2: | UNION & SHELDON | ||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500112260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152945802 | ||||||||
| FaxNumber: | 5152945457 | ||||||||
| Practice Location | |||||||||
| Address1: | 2260 THIELEN STUDENT HEALTH CENTER | ||||||||
| Address2: | UNION & SHELDON | ||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500112260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152945802 | ||||||||
| FaxNumber: | 5152945457 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | YEAKEL | ||||||||
| AuthorizedOfficialFirstName: | GREG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHARMACIST | ||||||||
| AuthorizedOfficialTelephone: | 5152944041 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0002X | Y | Suppliers | Pharmacy | Clinic Pharmacy |
No ID Information.