| NPI | 1497942205 |
|---|---|
| Doing Business As | PROHEALTH PHARMACY - OCONOMOWOC |
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHNSON Reimbursement Manager 262-928-4704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 8772) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2022-12-14 |