| NPI | 1184784159 |
|---|---|
| Doing Business As | THEDACARE PHARMACY - WAUTOMA |
| Entity Type | Organization |
| Authorized Contact | ALISSA GIES Pharmacist Of Record 920-787-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 7733-42) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2017-04-18 |