# CHET JOHNSON DRUGS, INC.

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

## Provider details

- **NPI number:** 1184711087
- **Authorized official:** MR. MATTHEW PAUL JOHNSON RPH (PRESIDENT)
- **Authorized official phone:** (715) 268-8121

## Contact information

- **Practice address:** 204 KELLER AVE N, AMERY, WI 54001-1036
- **Practice address phone:** (715) 268-8121
- **Practice address fax:** (715) 268-4733
- **Mailing address:** PO BOX 17, AMERY, WI 54000-0017
- **Mailing address phone:** (715) 268-8121
- **Mailing address fax:** (715) 268-4733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 4369042 | WI | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 09/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0490020001 | PTAN | — |
| 05 | — | 33100200 | — | WI |