DYKSTRA PHARMACY CO (NPI# 1477660512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477660512 |
| Entity Type | Organization |
| Organization Name | DYKSTRA PHARMACY CO |
| Other Organization Name | HULL PHARMACY |
| Practice Address |
1044 Main Street Box 309 Hull IA 51239 |
| Mailing Address |
1044 Main St Box 309 Hull IA 51238 |
| Practice Telephone | 7124391611 |
| Practice Fax Number | 7124391612 |
| Mailing Telephone | 7124391611 |
| Mailing Fax Number | 7124391612 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RICHARD K DYKSTRA (OWNER) |
| Authorized Official Telephone | 7124391611 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 183500000X | Pharmacist | 14742 | IA | Pharmacy Service Providers |
| X | 315P00000X | Intermediate Care Facility, Mentally Retarded | 14742 | IA | Nursing & Custodial Care Facilities |
| X | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
14742 | IA | Suppliers |
| X | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
14742 | IA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0081661 | 05 |
| Other Name | Type Code |
|---|---|
| Hull Pharmacy | Doing Business As Name - Organization |
| Street Address |
1044 MAIN STREET BOX 309 |
| City | HULL |
| State | IA |
| Zip Code | 51239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285874198 | Helen Jean Golden | Nurse Practitioner | 3459 Us 75 Ave, Hull, IA 51239 | 2009-03-05 |
| 1245390764 | Scott Rens | Family Medicine | 807 Main Street, Hull, IA 51239 | 2006-12-12 |
| 1760540173 | City of Hull | Emergency Medical Technician, Paramedic | 1133 Maple Street, Hull, IA 51239 | 2006-12-05 |
| 1316019243 | Leah Jo Destigter | Physical Therapist | 807 Main St., Suite C, Hull, IA 51239 | 2006-11-15 |
| 1831163088 | Bruce A Ewoldt | Chiropractor | 1134 Main St., Po Box 808, Hull, IA 51239 | 2006-02-15 |
| 1396878708 | Sioux Center Health | Family Medicine | 807 Main St, Hull, IA 51239 | 2007-03-14 |
| 1023177367 | Boyden-hull Community School District | Local Education Agency (LEA) | 801 First Street, Box 678, Hull, IA 51239-0678 | 2006-12-06 |
| 1649813726 | Tarah Kooima | Physical Medicine & Rehabilitation | 807 Main St Ste C, Hull, IA 51239-7204 | 2019-10-22 |
| 1699245381 | Dana Elaine Visser | Occupational Therapist | 807 Main Stree Suite C, Hull, IA 51239-7204 | 2018-11-26 |
| 1427369222 | Jamie Vitamvas | Family Medicine | 807 Main St Ste D, Hull, IA 51239-7204 | 2010-06-25 |
| Find all providers in zip 51239 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003355140 | Judy B Holloman | Pharmacist | 9161 Highway 29 S, Hull, GA 30646-3772 | 2017-02-22 |
| 1508303595 | Patricia S Chandler | Pharmacist | 9161 Hghwy 29 South, Hull, GA 30646 | 2017-01-27 |
| 1396901161 | Ansley Brooke Chambers | Pharmacist | 8895 Highway 29 S, Hull, GA 30646-3909 | 2008-07-31 |
| 1629639307 | Rocky Tenaglia | Pharmacist | 480 Nantasket Ave, Hull, MA 02045-2544 | 2019-06-24 |
| 1902383011 | Annmarie Sullivan | Pharmacist | 9161 Highway 29 S, Hull, GA 30646-3772 | 2018-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708070 | Bethany Vogts | Pharmacist | 1825 29th St Ne Ste E, Cedar Rapids, IA 52402-3452 | 2020-10-20 |
| 1356948103 | Kate Elizabeth Kurt | Pharmacist | 1605 Associates Dr Ste 101, Dubuque, IA 52002-2270 | 2020-10-05 |
| 1295348605 | Bret Kinne | Pharmacist | 120 S Story St Ste C, Boone, IA 50036-4739 | 2020-08-25 |
| 1770191611 | Andrea Dawn Mccartney | Pharmacist | 3056 River Crossing Ct Ste A, Riverside, IA 52327-4733 | 2020-07-16 |
| 1669080842 | Darby A Messerschmitt | Pharmacist | 118-120 North 1st Avenue, Winterset, IA 50273 | 2020-07-14 |
| 1558989194 | Joy C Tinnes | Pharmacist | 3056 River Crossing Ct, Riverside, IA 52327-4733 | 2020-07-09 |
| 1124645270 | David John Thomsen | Pharmacist | 133 Green Mountain Dr, Iowa City, IA 52245-3817 | 2020-07-05 |
| 1578180790 | Emily Brynn Vahary | Pharmacist | 200 Hawkins Dr # Cc101gh, Iowa City, IA 52242-1009 | 2020-07-03 |
| 1902422108 | Shanrael Stoner | Pharmacist | 2255 John F Kennedy Rd Ste 16, Dubuque, IA 52002-2883 | 2020-06-23 |
| 1235755000 | Casey Villhauer | Pharmacist | 4105 Nw 5th St, Ankeny, IA 50023-8710 | 2020-06-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.