Mercy Mall Pharmacy
LBN: Mercy Health System Corporation
Mercy Mall Pharmacy is an health care organization with primary practice located at 1010 N Washington St Suite 105, Janesville WI 53548-1561. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Mail Order Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Mercy Health System Corporation can be contacted via phone (608) 754-0286, or through Janczak, Don via phone (608) 756-6664.
Contact Information
Primary practice address
1010 N Washington St Suite 105
Janesville WI 53548-1561
Phone: (608) 754-0286
Fax: (608) 754-0027
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | 7720 | Wisconsin |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | ||
| Suppliers / Mail Order Pharmacy | 3336M0002X | 7720 | Wisconsin |
Profile Details
| NPI number | 1558307942 |
|---|---|
| LBN Legal business name | Mercy Health System Corporation |
| DBA Doing business as | Mercy Mall Pharmacy |
| Authorized official | Janczak, Don PHARMD |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Sep 27th, 2023 - about last year |
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 | 1558307942 | NPPES |
| Wisconsin | MEDICAID | 33227700 | |
| Wisconsin | Other | 5101263 |
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