Beaver Dam Hometown Pharmacy
LBN: Beaver Dam Hometown Pharmacy Llc
Beaver Dam Hometown Pharmacy is an health care organization with primary practice located at 609 N Spring St , Beaver Dam WI 53916-2040. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Beaver Dam Hometown Pharmacy Llc can be contacted via phone (920) 356-1500, or through Strause, Daniel via phone (920) 992-6800.
Contact Information
Primary practice address
609 N Spring St
Beaver Dam WI 53916-2040
Phone: (920) 356-1500
Fax: (920) 356-1510
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | 9411-42 | Wisconsin |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | ||
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1588036826 |
|---|---|
| LBN Legal business name | Beaver Dam Hometown Pharmacy Llc |
| DBA Doing business as | Beaver Dam Hometown Pharmacy |
| Authorized official | Strause, Daniel |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 27th, 2015 |
| Last updated | May 4th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588036826 | NPPES |
| Wisconsin | MEDICAID | 100050583 | |
| Wisconsin | Other | 2155039 |
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