Medford Pharmacy

LBN: Medford Pharmacy Inc
Medford Pharmacy is an health care organization with primary practice located at 210 S Main St , Medford WI 54451-1843. 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. Medford Pharmacy Inc can be contacted via phone (715) 748-4477, or through Prohaska, Josh via phone (715) 415-1981.

Contact Information

Primary practice address
210 S Main St Medford WI 54451-1843
Phone: (715) 748-4477
Fax: (715) 748-5848
Website:
Map and Directions
Authorized official contact:
Name: Prohaska, Josh
Phone: (715) 415-1981

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 9018-42 Wisconsin

Profile Details

NPI number 1811201742
LBN Legal business name Medford Pharmacy Inc
DBA Doing business as Medford Pharmacy
Authorized official Prohaska, Josh
Entity Organization
Organization subpart 1 No
Enumeration date Aug 3rd, 2010
Last updated Apr 4th, 2012 - about 12 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 1811201742 NPPES
Other 5132319 NCPDP PROVIDER IDENTIFICATION NUMBER

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