| Organization Name: | ATLANTIC MEDICAL CENTER PHARMACY, INC |
| NPI Number: | 1295827913 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUANN IHNKEN (OWNER/MANAGER) |
| Mailing Address: | 1501 E 10th St Atlantic |
| State: | IA US |
| Postal Code: | 500221936 |
| Phone Number: | 7122433367 |
| Fax Number: | 7122437529 |
| NPI Enumeration Date: | 09/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0002X |
| License Number: | 317 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Clinic Pharmacy |
| Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |