| Organization Name: | CENTRAL IOWA COMPOUNDING |
| NPI Number: | 1194855569 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN HORTON (OWNER PHARMACIST) |
| Mailing Address: | 3290 100th St Urbandale |
| State: | IA US |
| Postal Code: | 503223879 |
| Phone Number: | 5152527688 |
| Fax Number: | 5152527705 |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | 762 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |