Micklesen Drug

LBN: Micklesen Drug Inc
Micklesen Drug is an health care organization with primary practice located at 530 2Nd St , Hudson WI 54016-1799. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Micklesen Drug Inc can be contacted via phone (715) 386-3344, or through Anderson, Mark via phone (715) 386-3344.

Contact Information

Primary practice address
530 2Nd St Hudson WI 54016-1799
Phone: (715) 386-3344
Fax: (715) 386-5198
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Mark
Phone: (715) 386-3344

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X 4862-42 Wisconsin

Profile Details

NPI number 1033657283
LBN Legal business name Micklesen Drug Inc
DBA Doing business as Micklesen Drug
Authorized official Anderson, Mark
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2017
Last updated Jul 27th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033657283 NPPES
Wisconsin MEDICAID 33003000
Wisconsin Other 2167180

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