| NPI | 1588036826 |
|---|---|
| Doing Business As | BEAVER DAM HOMETOWN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DANIEL STRAUSE CEO 920-992-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WI 9411-42) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2020-05-04 |