# PRESCRIPTION CENTER PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PRESCRIPTION CENTER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477628055
- **Authorized official:** DAVID EICHSTAEDT (OWNER)
- **Authorized official phone:** (262) 567-7267

## Contact information

- **Practice address:** 888 THACKERAY TRL, STE 101, OCONOMOWOC, WI 53066-4342
- **Practice address phone:** (262) 567-7267
- **Practice address fax:** (262) 567-7244
- **Mailing address:** 888 THACKERAY TRL, STE 101, OCONOMOWOC, WI 53066-4342
- **Mailing address phone:** (262) 567-7267
- **Mailing address fax:** (262) 567-7244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 789742 | WI | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 02/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2113840 | PK | — |
| 05 | — | 33053200 | — | WI |