| NPI | 1104837616 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-08-10 |
| Last Updated | 2025-05-06 |
| Authorized Official | Lori Willis Acquisitions Manager Phone: 6413663440 |
| Mailing Address | Po Box 640 Conrad, IA 50621-0640 United States Phone: (641) 366-3440 | Fax: (641) 366-3442 📍 View Map |
| Primary Practice Address | 1002 6th St Nevada, IA 50201-1826 United States Phone: (515) 382-2485 | Fax: (515) 382-3473 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | IA | 0181032 | - |
| Other (non-Medicare) | - | 2136153 | PK |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | - | - |
| No | 333600000X – Pharmacy | - | - |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | IA | 482 |
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About NPI 1104837616
Nudak Ventures Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104837616. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Nevada, IA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-08-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104837616?
NPI 1104837616 belongs to Nudak Ventures Llc, a Pharmacy, Community/Retail Pharmacy in Nevada, IA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104837616 active?
The current status of NPI 1104837616 in the NPPES registry is Active. The record was last updated on 2025-05-06.
What specialty is NPI 1104837616?
NPI 1104837616 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104837616?
You can verify NPI 1104837616 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104837616?
The primary practice address on file for NPI 1104837616 is 1002 6th St, Nevada, IA 50201-1826. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104837616 issued?
NPI 1104837616 was first issued (enumerated) on 2006-08-10. The NPPES record was last updated on 2025-05-06.
Practice Location Map
Nudak Ventures Llc is located at 1002 6th St, Nevada, IA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Nudak Ventures Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104837616. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 482 | IA |