Provider Demographics
NPI:1174515001
Name:STANGEL PHARMACY INC
Entity type:Organization
Organization Name:STANGEL PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-423-1131
Mailing Address - Street 1:821 IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:ONAWA
Mailing Address - State:IA
Mailing Address - Zip Code:51040-1629
Mailing Address - Country:US
Mailing Address - Phone:712-423-1131
Mailing Address - Fax:712-423-3214
Practice Address - Street 1:821 IOWA AVE
Practice Address - Street 2:
Practice Address - City:ONAWA
Practice Address - State:IA
Practice Address - Zip Code:51040-1629
Practice Address - Country:US
Practice Address - Phone:712-423-1131
Practice Address - Fax:712-423-3214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336H0001X, 332B00000X
IA5743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE42105728000Medicaid
2026619OtherPK
IA0132969Medicaid
0136300001Medicare NSC