| NPI | 1952179277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MICHELE HADZIMA Director Of Business Services 715-531-6812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2023-12-15 |