Provider Demographics
NPI:1083447536
Name:GROSSMANN, AUSTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:GROSSMANN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 PAINTED WOODS DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8440
Mailing Address - Country:US
Mailing Address - Phone:515-707-8250
Mailing Address - Fax:
Practice Address - Street 1:2929 WESTOWN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1319
Practice Address - Country:US
Practice Address - Phone:515-440-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist