| NPI | 1679801807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY BASSEUNER Pharmacy Technician 608-784-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: WI 9122-042) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2016-08-11 |