Provider Demographics
NPI:1063534154
Name:TOWNCREST COMPOUNDING LLC
Entity type:Organization
Organization Name:TOWNCREST COMPOUNDING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPOUDING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBUBGER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH PHD
Authorized Official - Phone:319-337-3536
Mailing Address - Street 1:2306 MUSCATINE AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6637
Mailing Address - Country:US
Mailing Address - Phone:319-337-3526
Mailing Address - Fax:319-337-5271
Practice Address - Street 1:901 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-5211
Practice Address - Country:US
Practice Address - Phone:319-688-4386
Practice Address - Fax:319-337-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA13183336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy