| NPI | 1699793380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE SPEERS Pharmacist In Charge 608-251-4454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WI 6464) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-08-24 |