Evansville Hometown Pharmacy
LBN: Md Group Llc
Evansville Hometown Pharmacy is an health care organization with primary practice located at 21 W Main St , Evansville WI 53536-1143. 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 / Community/Retail Pharmacy is the primary health care specialty.
Md Group Llc can be contacted via phone (608) 882-4550, or through Deans, Diane via phone (920) 992-6800.
Contact Information
Primary practice address
21 W Main St
Evansville WI 53536-1143
Phone: (608) 882-4550
Fax: (608) 882-0149
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
Suppliers / Pharmacy | 333600000X | ||
Suppliers / Community/Retail Pharmacy | 3336C0003X | 8433-42 | Wisconsin |
Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
NPI number | 1598768137 |
---|---|
LBN Legal business name | Md Group Llc |
DBA Doing business as | Evansville Hometown Pharmacy |
Authorized official | Deans, Diane |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | May 27th, 2005 |
Last updated | Jul 19th, 2018 - about 6 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 | 1598768137 | NPPES |
Other | 2114593 | PK | |
MEDICAID | 33266200 | PK |
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