Mallatt'S Pharmacy And Costumes #103
LBN: Mike Flint Enterprises Inc
Mallatt'S Pharmacy And Costumes #103 is an health care organization with primary practice located at 801 N Main St , Lodi WI 53555-1279. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Mike Flint Enterprises Inc can be contacted via phone (608) 592-3256, or through Flint, John Michael via phone (608) 310-9922.
Contact Information
Primary practice address
801 N Main St
Lodi WI 53555-1279
Phone: (608) 592-3256
Fax: (608) 592-7406
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 9156-42 | Wisconsin |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1144324195 |
|---|---|
| LBN Legal business name | Mike Flint Enterprises Inc |
| DBA Doing business as | Mallatt'S Pharmacy And Costumes #103 |
| Authorized official | Flint, John Michael |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | May 18th, 2015 - about 9 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 | 1144324195 | NPPES |
| Wisconsin | MEDICAID | 1144324195 | |
| Wisconsin | Other | 2137294 |
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