NPI | 1346251840 |
---|---|
Doing Business As | GHC SAUK TRAILS PHARMACY |
Entity Type | Organization |
Authorized Contact | LAURIE FLAGEL DEAN Operation COO Rdinator 608-828-4811 |
Organization Subpart ? | No |
Primary Taxonomy | 3336M0003X Pharmacy, Managed Care Organization Pharmacy (Licence: WI 7386-42) |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
Enumeration Date | 2006-08-10 |
Last Update Date | 2016-09-30 |