Evansville Hometown Pharmacy

LBN: Md Group Llc
Evansville Hometown Pharmacy is an health care organization with primary practice located at 21 W Main St , Evansville WI 53536-1143. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, 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) 882-4550, or through Deans, Diane via phone (920) 992-6800.

Contact Information

Primary practice address
21 W Main St Evansville WI 53536-1143
Phone: (608) 882-4550
Fax: (608) 882-0149
Website:
Map and Directions
Authorized official contact:
Name: Deans, Diane
Phone: (920) 992-6800

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8433-42 Wisconsin
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1598768137
LBN Legal business name Md Group Llc
DBA Doing business as Evansville Hometown Pharmacy
Authorized official Deans, Diane
Entity Organization
Organization subpart 1 No
Enumeration date May 27th, 2005
Last updated Jul 19th, 2018 - about 7 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 1598768137 NPPES
Other 2114593 PK
MEDICAID 33266200 PK

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