# BENZER WI 2 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peshtigo Pharmacy, Peshtigo Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467454678
- **Authorized official:** BHARGAVI PATEL (OWNER)
- **Authorized official phone:** (810) 348-3003

## Contact information

- **Practice address:** 220 FRENCH ST, PESHTIGO, WI 54157-1218
- **Practice address phone:** (715) 582-4237
- **Practice address fax:** (715) 582-0213
- **Mailing address:** 220 FRENCH STREET, PESHTIGO, WI 54157
- **Mailing address phone:** (813) 304-2221
- **Mailing address fax:** (888) 239-8423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9304-42 | WI | — |
| 3336C0003X | Community/Retail Pharmacy | 9491-42 | WI | Yes |

## Other

- **Enumeration date:** 06/01/2005
- **Last updated:** 10/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2151000 | PK | — |
| 05 | — | 33094900 | — | WI |