Provider Demographics
NPI:1861617011
Name:STRAW, DEBRA LEE (RPH)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEE
Last Name:STRAW
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5888 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1623
Mailing Address - Country:US
Mailing Address - Phone:515-276-2961
Mailing Address - Fax:515-254-2242
Practice Address - Street 1:6105 MERLE HAY RD
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1224
Practice Address - Country:US
Practice Address - Phone:515-278-5503
Practice Address - Fax:515-254-2242
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist