Three Lakes Pharmacy

LBN: Moe Drugs Llc
Three Lakes Pharmacy is an health care organization with primary practice located at 1790 Superior St , Three Lakes WI 54562-9046. 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. Moe Drugs Llc can be contacted via phone (715) 546-3266, or through Moe, Seth via phone (920) 639-1384.

Contact Information

Primary practice address
1790 Superior St Three Lakes WI 54562-9046
Phone: (715) 546-3266
Fax: (715) 546-2912
Website:
Map and Directions
Authorized official contact:
Name: Moe, Seth
Phone: (920) 639-1384

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 9400-42 Wisconsin

Profile Details

NPI number 1104285907
LBN Legal business name Moe Drugs Llc
DBA Doing business as Three Lakes Pharmacy
Authorized official Moe, Seth
Entity Organization
Organization subpart 1 No
Enumeration date Feb 22nd, 2016
Last updated Feb 20th, 2017 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104285907 NPPES
Other 2158870 PK
MEDICAID 100055480 PK

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