Co-Op Pharmacy

LBN: Northern Lakes Cooperative
Co-Op Pharmacy is an health care organization with primary practice located at 15846 W Us Highway 63 S , Hayward WI 54843-7106. 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. Northern Lakes Cooperative can be contacted via phone (715) 634-8238, or through Covelli, Michael via phone (715) 634-3211.

Contact Information

Primary practice address
15846 W Us Highway 63 S Hayward WI 54843-7106
Phone: (715) 634-8238
Fax: (715) 634-8170
Website:
Map and Directions
Authorized official contact:
Name: Covelli, Michael
Phone: (715) 634-3211

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 7348-42 Wisconsin

Profile Details

NPI number 1922044411
LBN Legal business name Northern Lakes Cooperative
DBA Doing business as Co-Op Pharmacy
Authorized official Covelli, Michael
Entity Organization
Organization subpart 1 No
Enumeration date Jun 21st, 2006
Last updated Nov 2nd, 2021 - about 5 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 1922044411 NPPES
Other 2115372 PK
MEDICAID 33197400 PK

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