County Market Pharmacy

LBN: Jerrys Enterprises Inc
County Market Pharmacy is an health care organization with primary practice located at 220 S 18Th Ave , Wausau WI 54401-4252. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Jerrys Enterprises Inc can be contacted via phone (715) 842-3541, or through Hoehn, Keith via phone (715) 218-3925.

Contact Information

Primary practice address
220 S 18Th Ave Wausau WI 54401-4252
Phone: (715) 842-3541
Fax: (715) 845-5306
Website:
Map and Directions
Authorized official contact:
Name: Hoehn, Keith RPH
Phone: (715) 218-3925

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8362042 Wisconsin

Profile Details

NPI number 1588778575
LBN Legal business name Jerrys Enterprises Inc
DBA Doing business as County Market Pharmacy
Authorized official Hoehn, Keith RPH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 18th, 2006
Last updated Nov 24th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588778575 NPPES
Other 2113198 PK
MEDICAID 33271600 PK

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