# MOUNT HOREB FAMILY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mount Horeb Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003914045
- **Authorized official:** JENNIFER WEILAND (BUSINESS MANAGER/OWNER)
- **Authorized official phone:** (608) 437-3001

## Contact information

- **Practice address:** 203 W MAIN ST, MOUNT HOREB, WI 53572-1914
- **Practice address phone:** (608) 437-3001
- **Practice address fax:** (608) 437-6480
- **Mailing address:** 203 W MAIN ST, MOUNT HOREB, WI 53572-1914
- **Mailing address phone:** (608) 437-3001
- **Mailing address fax:** (608) 437-6480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 835442 | WI | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 06/08/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2112892 | PK | — |
| 05 | — | 33271700 | — | WI |
| 01 | — | K300846024 | MEDICARE PTAN | — |