| NPI | 1841900321 |
|---|---|
| Doing Business As | THE MEDICINE SHOPPE 1564 - LTC |
| Entity Type | Organization |
| Authorized Contact | MARVIN ROBERT MOORE President 920-794-1225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2022-11-25 |
| Last Update Date | 2022-11-25 |