Provider Demographics
NPI:1962240481
Name:MITCHELL COUNTY PHARMACIES LLC
Entity type:Organization
Organization Name:MITCHELL COUNTY PHARMACIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GODDARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-732-6086
Mailing Address - Street 1:616 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:OSAGE
Mailing Address - State:IA
Mailing Address - Zip Code:50461-1456
Mailing Address - Country:US
Mailing Address - Phone:641-732-6086
Mailing Address - Fax:641-732-6028
Practice Address - Street 1:713 WOODLAND AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:RICEVILLE
Practice Address - State:IA
Practice Address - Zip Code:50466
Practice Address - Country:US
Practice Address - Phone:641-985-2380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MITCHELL COUNTY PHARMACIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy