# CORCORAN HEALTHCARE ENTERPRISES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Reedsburg Family Prescription Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174689616
- **Authorized official:** CINDY L. KISSACK RPH (MANAGER)
- **Authorized official phone:** (608) 524-3215

## Contact information

- **Practice address:** 115 2ND ST, REEDSBURG, WI 53959-1602
- **Practice address phone:** (608) 524-3215
- **Practice address fax:** (608) 524-8410
- **Mailing address:** 115 2ND ST, PO BOX 245, REEDSBURG, WI 53959-1602
- **Mailing address phone:** (608) 524-3215
- **Mailing address fax:** (608) 524-8410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 11077 | WI | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33168300 | — | WI |