Wally Shong Pharmacy

LBN: Pharmacare Ltd
Wally Shong Pharmacy is an health care organization with primary practice located at 153 W Lincoln St , Augusta WI 54722-9152. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Pharmacare Ltd can be contacted via phone (715) 286-2515, or through Henke, Brandin via phone (715) 833-6770.

Contact Information

Primary practice address
153 W Lincoln St Augusta WI 54722-9152
Phone: (715) 286-2515
Fax: (715) 286-4102
Website:
Map and Directions
Authorized official contact:
Name: Henke, Brandin
Phone: (715) 833-6770

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1104928902
LBN Legal business name Pharmacare Ltd
DBA Doing business as Wally Shong Pharmacy
Authorized official Henke, Brandin
Entity Organization
Organization subpart 1 No
Enumeration date Sep 2nd, 2006
Last updated May 11th, 2023 - about 3 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 1104928902 NPPES
Wisconsin MEDICAID 33263400

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