# NORTHBAY PHARMACY, INC

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

## Provider details

- **NPI number:** 1245335835
- **Authorized official:** WILLIAM RAY DREGER R.PH. (PHARMACIST)
- **Authorized official phone:** (715) 453-5996

## Contact information

- **Practice address:** 686 N 4TH ST, P.O. 228, TOMAHAWK, WI 54487-2123
- **Practice address phone:** (715) 453-5996
- **Practice address fax:** (715) 453-4508
- **Mailing address:** 686 N 4TH ST, P.O. 228, TOMAHAWK, WI 54487-2123
- **Mailing address phone:** (715) 453-5996
- **Mailing address fax:** (715) 453-4508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 6710-042 | WI | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 07/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33033200 | — | WI |