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Organization
CARL JEFFREY ELIASON
Active
Organization
CARL JEFFREY ELIASON
Active
Other names
Peoples Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL JEFF ELIASON PHARMACIST (OWNER PHARMACIST)
(715) 394-7765
Entity
Organization
Contact information
Practice address
1124 BELKNAP ST, SUPERIOR, WI 54880-2856
(715) 394-7765
(715) 394-7765
Mailing address
1124 BELKNAP ST, SUPERIOR, WI 54880-2856
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10055040
WI
332BC3200X
Customized Equipment (DME)
—
—
333600000X
Pharmacy
7047042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33075100
—
WI
Enumeration date
03/13/2007
Last updated
09/05/2008
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