Deforest Hometown Pharmacy

LBN: Md Group, Llc
Deforest Hometown Pharmacy is an health care organization with primary practice located at 645 S Main St , Deforest WI 53532-1421. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Md Group, Llc can be contacted via phone (608) 846-4736, or through Strause, Daniel via phone (920) 992-6800.

Contact Information

Primary practice address
645 S Main St Deforest WI 53532-1421
Phone: (608) 846-4736
Fax: (608) 846-6892
Website:
Map and Directions
Authorized official contact:
Name: Strause, Daniel
Phone: (920) 992-6800

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1427163476
LBN Legal business name Md Group, Llc
DBA Doing business as Deforest Hometown Pharmacy
Authorized official Strause, Daniel
Entity Organization
Organization subpart 1 No
Enumeration date Aug 20th, 2006
Last updated May 23rd, 2024 - about 2 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 1427163476 NPPES
Other 5129312 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID WI33266300 NCPDP PROVIDER IDENTIFICATION NUMBER

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