Deforest Hometown Pharmacy
LBN: Md Group, Llc
Deforest Hometown Pharmacy is an health care organization with primary practice located at 645 S Main St , Deforest WI 53532-1421. 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, Llc can be contacted via phone (608) 846-4736, or through Strause, Daniel via phone (920) 992-6800.
Contact Information
Primary practice address
645 S Main St
Deforest WI 53532-1421
Phone: (608) 846-4736
Fax: (608) 846-6892
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
Suppliers / Community/Retail Pharmacy | 3336C0003X | ||
Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
NPI number | 1427163476 |
---|---|
LBN Legal business name | Md Group, Llc |
DBA Doing business as | Deforest Hometown Pharmacy |
Authorized official | Strause, Daniel |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Aug 20th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1427163476 | NPPES |
Other | 5129312 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
MEDICAID | WI33266300 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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