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Organization
MICKLESEN DRUG INC
Active
Organization
MICKLESEN DRUG INC
Active
Other names
MICKLESEN DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ANDERSON (PHARMACIST)
(715) 386-3344
Entity
Organization
Contact information
Practice address
530 2ND ST, HUDSON, WI 54016-1799
(715) 386-3344
(715) 386-5198
Mailing address
530 2ND ST, HUDSON, WI 54016-1799
(715) 386-3344
(715) 386-5198
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
4862-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167180
PK
—
05
—
33003000
—
WI
Enumeration date
02/08/2017
Last updated
09/19/2025
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