| NPI | 1184711087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PAUL JOHNSON President 715-268-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 4369042) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2015-08-20 |