Port Family Pharmacy, Inc.

LBN: Port Family Pharmacy, Inc.
Port Family Pharmacy, Inc. is an health care organization with primary practice located at 1021 N Wisconsin St , Port Washington WI 53074-1207. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Port Family Pharmacy, Inc. can be contacted via phone (262) 261-3900, or through Vineburg, Michael J via phone (262) 261-3900.

Contact Information

Primary practice address
1021 N Wisconsin St Port Washington WI 53074-1207
Phone: (262) 261-3900
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Vineburg, Michael J PHARMD.
Phone: (262) 261-3900

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1184353807
LBN Legal business name Port Family Pharmacy, Inc.
DBA Doing business as
Authorized official Vineburg, Michael J PHARMD.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 8th, 2022
Last updated May 4th, 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 1184353807 NPPES
Wisconsin MEDICAID 100216135

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