| NPI | 1427514504 |
|---|---|
| Doing Business As | NORTHLAND HOMETOWN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DIANE DEANS Contracting Specialist 920-992-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2021-12-21 |