NPI | 1790778967 |
---|---|
Doing Business As | LARSEN MAYER PHARMACY |
Entity Type | Organization |
Authorized Contact | RAYMOND LARSEN President 262-658-8124 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 8019-42) |
Enumeration Date | 2005-08-23 |
Last Update Date | 2010-10-06 |