Randolph Hometown Pharmacy

LBN: Md Group Ii Llc
Randolph Hometown Pharmacy is an health care organization with primary practice located at 107 N High St , Randolph WI 53956-1267. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Md Group Ii Llc can be contacted via phone (920) 326-5242, or through Strause, Daniel via phone (920) 992-6800.

Contact Information

Primary practice address
107 N High St Randolph WI 53956-1267
Phone: (920) 326-5242
Fax: (920) 326-3765
Website:
Map and Directions
Authorized official contact:
Name: Strause, Daniel
Phone: (920) 992-6800

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8437042 Wisconsin
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1356383822
LBN Legal business name Md Group Ii Llc
DBA Doing business as Randolph Hometown Pharmacy
Authorized official Strause, Daniel
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2006
Last updated May 23rd, 2024 - about 7 months 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 1356383822 NPPES
Other 5108940 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 33269600 NCPDP PROVIDER IDENTIFICATION NUMBER

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