# FOX VALLEY HEMATOLOGY & ONCOLOGY S C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fox Valley Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003352733
- **Authorized official:** TIMOTHY GOGGINS (CHIEF MEDICAL OFFICER/PHYSICIAN)
- **Authorized official phone:** (920) 749-1171

## Contact information

- **Practice address:** 3925 N GATEWAY DR, SUITE 100, APPLETON, WI 54913-7863
- **Practice address phone:** (920) 702-4802
- **Practice address fax:** (920) 702-4319
- **Mailing address:** 3232 N BALLARD RD, SUITE 200, APPLETON, WI 54911-8804
- **Mailing address phone:** (920) 749-9668
- **Mailing address fax:** (920) 734-5307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9433-42 | WI | Yes |

## Other

- **Enumeration date:** 01/19/2017
- **Last updated:** 05/08/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2167333 | PK | — |