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Organization
MORTON DRUG CO INC
Active
Organization
MORTON DRUG CO INC
Active
Other names
MORTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY BLANK (VP CORPORATE SERVICES)
(920) 727-8882
Entity
Organization
Contact information
Practice address
N162 EISENHOWER DR, SUITE 100, APPLETON, WI 54915-6171
(920) 731-4830
(920) 731-4709
Mailing address
PO BOX 778, NEENAH, WI 54957-0778
(920) 727-3853
(920) 727-3867
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
8535
WI
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33286500
—
WI
01
—
5104803
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/07/2006
Last updated
09/08/2010
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