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Organization
LADD MEMORIAL HOSPITAL
Active
Organization
LADD MEMORIAL HOSPITAL
Active
Other names
Osceola Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MATT FORGE (CHIEF EXECUTIVE OFFICER)
(715) 294-5622
Entity
Organization
Contact information
Practice address
2600 65TH AVENUE, OSCEOLA, WI 54020-0218
(715) 294-4050
(715) 294-5690
Mailing address
PO BOX 218, OSCEOLA, WI 54020-0218
(715) 294-4050
(715) 294-5690
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9071-042
WI
Other
Enumeration date
05/04/2011
Last updated
01/10/2020
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