NPI | 1417156209 |
---|---|
Doing Business As | UVANTA PHARMACY OF LACROSSE |
Entity Type | Organization |
Authorized Contact | JEFF VANSTRATEN Owner 262-347-9405 |
Organization Subpart ? | No |
Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WI 8750042) |
Enumeration Date | 2007-07-12 |
Last Update Date | 2011-08-09 |