Vallandingham, Jack Robert

Vallandingham, Jack Robert is an sole proprietor health care provider with primary practice located at 100 N Main St , Sigourney IA 52591-1414. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Vallandingham, Jack Robert can be contacted via phone (641) 622-3184.

Contact Information

Primary practice address
100 N Main St Sigourney IA 52591-1414
Phone: (641) 622-3184
Fax: (641) 622-1054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 13888 Iowa

Profile Details

NPI number 1013068493
LBN Legal business name Vallandingham, Jack Robert
Credentials RPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 14th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013068493 NPPES
Iowa MEDICAID 0181529
Iowa Other 1607324

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