# PARK PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARK PHARMACY INC
- **Other names:** North Central IV
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316940679
- **Legal business name:** PARK PHARMACY INC
- **Authorized official:** MR. MARK PECHACEK (OWNER)
- **Authorized official phone:** (715) 762-3248

## Contact information

- **Practice address:** 138 1/2 2ND AVE N, PARK FALLS, WI 54552-1214
- **Practice address phone:** (715) 762-3248
- **Practice address fax:** (715) 762-2980
- **Mailing address:** 138 1/2 2ND AVE N, PARK FALLS, WI 54552-1214
- **Mailing address phone:** (715) 762-3248
- **Mailing address fax:** (715) 762-2980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 7643-042 | WI | — |
| 3336L0003X | Long Term Care Pharmacy | 7643-42 | WI | Yes |

## Other

- **Enumeration date:** 05/31/2005
- **Last updated:** 05/03/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33220500 | — | WI |