| NPI | 1255414330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROLD R GRASSMAN Owner/President/Pharmacist 715-284-4354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 7290042) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2010-05-03 |