# VILLAGE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124031463
- **Authorized official:** JEFFREY DEAN HINES RPH (OWNER PRESIDENT)
- **Authorized official phone:** (920) 897-5333

## Contact information

- **Practice address:** 633 N HWY 141, BOX 186, COLEMAN, WI 54112-0186
- **Practice address phone:** (920) 897-5333
- **Practice address fax:** (920) 897-5451
- **Mailing address:** 633 N HWY 141, BOX 186, COLEMAN, WI 54112-0186
- **Mailing address phone:** (920) 897-5333
- **Mailing address fax:** (920) 897-5451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 8460 | WI | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33257500 | — | WI |
| 01 | — | 5126582 | NCPDP | WI |