Provider Demographics
NPI:1104852318
Name:UNION DRUG INC
Entity type:Organization
Organization Name:UNION DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:METCALF
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACY
Authorized Official - Phone:563-422-3721
Mailing Address - Street 1:315 HIGHWAY 150 N
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:IA
Mailing Address - Zip Code:52175-1048
Mailing Address - Country:US
Mailing Address - Phone:563-422-3721
Mailing Address - Fax:563-422-3721
Practice Address - Street 1:315 HIGHWAY 150 N
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:IA
Practice Address - Zip Code:52175-1048
Practice Address - Country:US
Practice Address - Phone:563-422-3721
Practice Address - Fax:563-422-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 333600000X
IA563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0098897Medicaid
2026097OtherPK
IA0098897Medicaid