# PORT FAMILY PHARMACY, INC.

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

## Provider details

- **NPI number:** 1124718630
- **Authorized official:** MICHAEL VINEBURG (OWNER)
- **Authorized official phone:** (262) 261-3900

## Contact information

- **Practice address:** 1021 N WISCONSIN ST, PORT WASHINGTON, WI 53074-1207
- **Practice address phone:** (262) 261-3900
- **Mailing address:** 1021 N WISCONSIN ST, PORT WASHINGTON, WI 53074-1207
- **Mailing address phone:** (262) 261-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/09/2023
- **Last updated:** 05/09/2023