# CROSS PLAINS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CROSS PLAINS PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528173572
- **Authorized official:** LISA KOSTECKI RPH (OWNER)
- **Authorized official phone:** (608) 798-3031

## Contact information

- **Practice address:** 1840 MAIN ST, CROSS PLAINS, WI 53528-9473
- **Practice address phone:** (608) 798-3031
- **Practice address fax:** (608) 798-3932
- **Mailing address:** PO BOX 215, CROSS PLAINS, WI 53528-0215
- **Mailing address phone:** (608) 798-3031
- **Mailing address fax:** (608) 798-3932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 829842 | WI | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 02/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2112693 | PK | — |
| 05 | — | 33268700 | — | WI |