Provider Demographics
NPI:1447284666
Name:ANKENY APOTHECARY, INC.
Entity type:Organization
Organization Name:ANKENY APOTHECARY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEURER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:515-964-8550
Mailing Address - Street 1:107 NE DELAWARE AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-6691
Mailing Address - Country:US
Mailing Address - Phone:515-964-8550
Mailing Address - Fax:515-963-4055
Practice Address - Street 1:107 NE DELAWARE AVE STE 6
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-6691
Practice Address - Country:US
Practice Address - Phone:515-964-8550
Practice Address - Fax:515-963-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA7283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0459974Medicaid
IA1621297OtherNCPDP #
IA1621297OtherNCPDP #
IAP00411230Medicare PIN
IA5440380001Medicare NSC
IAI19999Medicare PIN