| NPI | 1043938202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOHNSON Owner 715-268-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2022-08-18 |