# KEALEY PHARMACY & HOME CARE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KEALEY PHARMACY AND HOMECARE INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033243845
- **Authorized official:** MARK JOHNSON RPH (OWNER / PRESIDENT)
- **Authorized official phone:** (608) 752-7869

## Contact information

- **Practice address:** 21 S JACKSON ST, JANESVILLE, WI 53548-3859
- **Practice address phone:** (608) 752-7869
- **Practice address fax:** (608) 752-6806
- **Mailing address:** PO BOX 8005, JANESVILLE, WI 53547-8005
- **Mailing address phone:** (608) 752-7869
- **Mailing address fax:** (608) 752-6806

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 7301-042 | WI | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 06/14/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2111847 | PK | — |
| 05 | — | 33117200 | — | WI |