Provider Demographics
NPI:1992893259
Name:PARKER, CHRISTOPHER P (PHARMD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:P
Last Name:PARKER
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 1:5002 WAGNER RD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52214-9531
Mailing Address - Country:US
Mailing Address - Phone:319-437-5002
Mailing Address - Fax:
Practice Address - Street 1:805 JOHNSON ST SW
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:IA
Practice Address - Zip Code:52033-8636
Practice Address - Country:US
Practice Address - Phone:563-852-7757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA204011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0014894Medicaid