<Unavail>

LBN: Mccullough Pharmacy Inc
<Unavail> is an health care organization with primary practice located at 547 Kenosha St , Walworth WI 53184-9512. 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. Mccullough Pharmacy Inc can be contacted via phone (262) 275-2137, or through Mccullough, James via phone (262) 248-8582.

Contact Information

Primary practice address
547 Kenosha St Walworth WI 53184-9512
Phone: (262) 275-2137
Fax: (262) 275-5743
Website:
Map and Directions
Authorized official contact:
Name: Mccullough, James
Phone: (262) 248-8582

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5931042 Wisconsin

Profile Details

NPI number 1881703676
LBN Legal business name Mccullough Pharmacy Inc
DBA Doing business as <Unavail>
Authorized official Mccullough, James
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2006
Last updated Sep 13th, 2007 - about 19 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 1881703676 NPPES
Wisconsin MEDICAID 33086500
Wisconsin Other 5110022

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