Provider Demographics
NPI:1447809587
Name:ANGLEMYER, TAYLOR C (PHARMD)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:C
Last Name:ANGLEMYER
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 1:400 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:IA
Mailing Address - Zip Code:50129-1420
Mailing Address - Country:US
Mailing Address - Phone:402-216-8519
Mailing Address - Fax:515-386-8521
Practice Address - Street 1:400 N ELM ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:IA
Practice Address - Zip Code:50129-1420
Practice Address - Country:US
Practice Address - Phone:402-216-8519
Practice Address - Fax:515-386-8521
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist