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Organization
KAUKAUNA PRESCRIPTION CENTER
Active
Organization
KAUKAUNA PRESCRIPTION CENTER
Active
Other names
CONSUMER PRESCRIPTION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME WALLENFANG RPH (OWNER AND CEO)
(920) 766-9200
Entity
Organization
Contact information
Practice address
200 E 2ND ST, KAUKAUNA, WI 54130-2524
(920) 766-9200
(920) 766-7998
Mailing address
200 E 2ND ST, KAUKAUNA, WI 54130-2524
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
8079042
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33127100
—
WI
01
—
5112393
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/14/2006
Last updated
09/11/2025
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