River Prairie Pharmacy

LBN: River Prairie Pharmacy
River Prairie Pharmacy is an health care organization with primary practice located at 1490 Rivers Edge Trl , Altoona WI 54720-2755. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. River Prairie Pharmacy can be contacted via phone (715) 828-2368, or through Defatta, Robert Joseph via phone (715) 828-2368.

Contact Information

Primary practice address
1490 Rivers Edge Trl Altoona WI 54720-2755
Phone: (715) 828-2368
Fax: (715) 839-7796
Website:
Map and Directions
Authorized official contact:
Name: Defatta, Robert Joseph Doctor of Medicine (MD)
Phone: (715) 828-2368

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1598346587
LBN Legal business name River Prairie Pharmacy
DBA Doing business as
Authorized official Defatta, Robert Joseph Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2021
Last updated Apr 20th, 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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