<Unavail>
LBN: Village Bake Shop Inc
<Unavail> is an health care organization with primary practice located at 3954 Mormon Coulee Rd , La Crosse WI 54601-7916. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Village Bake Shop Inc can be contacted via phone (608) 784-6200, or through Berg, James via phone (608) 784-6200.
Contact Information
Primary practice address
3954 Mormon Coulee Rd
La Crosse WI 54601-7916
Phone: (608) 784-6200
Fax: (608) 784-3808
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 7708-42 | Wisconsin |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1073606406 |
|---|---|
| LBN Legal business name | Village Bake Shop Inc |
| DBA Doing business as | <Unavail> |
| Authorized official | Berg, James RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 30th, 2006 |
| Last updated | May 19th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073606406 | NPPES |
| Wisconsin | MEDICAID | 33060500 | |
| Wisconsin | Other | 5104687 | |
| Wisconsin | MEDICAID | 636560400 |
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