| NPI | 1811201742 |
|---|---|
| Doing Business As | MEDFORD PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOSH PROHASKA President 715-415-1981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 9018-42) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2012-04-04 |