County Market Pharmacy

LBN: Jerrys Enterprises Inc
County Market Pharmacy is an health care organization with primary practice located at 2310 Crest View Dr , Hudson WI 54016-9315. 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) 381-5923, or through Larson, Joyce via phone (952) 928-1698.

Contact Information

Primary practice address
2310 Crest View Dr Hudson WI 54016-9315
Phone: (715) 381-5923
Fax: (715) 381-5993
Website:
Map and Directions
Authorized official contact:
Name: Larson, Joyce R.PH.
Phone: (952) 928-1698

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8363-42 Wisconsin

Profile Details

NPI number 1609969039
LBN Legal business name Jerrys Enterprises Inc
DBA Doing business as County Market Pharmacy
Authorized official Larson, Joyce R.PH.
Entity Organization
Organization subpart 1 No
Enumeration date Sep 30th, 2006
Last updated Feb 20th, 2017 - about 7 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 1609969039 NPPES
Other 2108748 PK
MEDICAID 33272100 PK

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