| NPI | 1437668613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN REABE Pharmacy Manager 920-623-1381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: WI 6020-42) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2017-09-20 |