Modern Apothecary

LBN: Modern Apothecary, Llc
Modern Apothecary is an health care organization with primary practice located at 5700 6Th Ave , Kenosha WI 53140-4104. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Modern Apothecary, Llc can be contacted via phone (262) 997-9573, or through Merritt, Erin E via phone (262) 997-9573.

Contact Information

Primary practice address
5700 6Th Ave Kenosha WI 53140-4104
Phone: (262) 997-9573
Fax: (262) 997-9574
Website:
Map and Directions
Authorized official contact:
Name: Merritt, Erin E PHARMD
Phone: (262) 997-9573

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 9274-42 Wisconsin
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1407265598
LBN Legal business name Modern Apothecary, Llc
DBA Doing business as Modern Apothecary
Authorized official Merritt, Erin E PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Aug 4th, 2014
Last updated Jan 31st, 2024 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407265598 NPPES
Other 5134476 NCPDP NUMBER

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