Provider Demographics
NPI:1104412089
Name:HOOPES, BETHANY LEA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:LEA
Last Name:HOOPES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19074 COUNTY ROAD G40
Mailing Address - Street 2:
Mailing Address - City:LETTS
Mailing Address - State:IA
Mailing Address - Zip Code:52754-9403
Mailing Address - Country:US
Mailing Address - Phone:319-929-4266
Mailing Address - Fax:319-228-8101
Practice Address - Street 1:122 MAIN ST
Practice Address - Street 2:
Practice Address - City:VAN HORNE
Practice Address - State:IA
Practice Address - Zip Code:52346-9718
Practice Address - Country:US
Practice Address - Phone:319-228-8100
Practice Address - Fax:319-228-8101
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19744183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist