Peshtigo Hometown Pharmacy

LBN: Peshtigo Hometown Pharmacy Llc
Peshtigo Hometown Pharmacy is an health care organization with primary practice located at 960 Frontage Rd , Peshtigo WI 54157-1702. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Peshtigo Hometown Pharmacy Llc can be contacted via phone (715) 582-0898, or through Strause, Daniel via phone (920) 992-6800.

Contact Information

Primary practice address
960 Frontage Rd Peshtigo WI 54157-1702
Phone: (715) 582-0898
Fax: (715) 582-0897
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 9341-42 Wisconsin
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1801262662
LBN Legal business name Peshtigo Hometown Pharmacy Llc
DBA Doing business as Peshtigo Hometown Pharmacy
Authorized official Strause, Daniel
Entity Organization
Organization subpart 1 No
Enumeration date Aug 17th, 2015
Last updated Apr 29th, 2020 - about 6 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 1801262662 NPPES
Other 2153606 PK
MEDICAID 100048562 PK

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