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Organization
MIKE FLINT ENTERPRISES INC
Active
Organization
MIKE FLINT ENTERPRISES INC
Active
Other names
MALLATT'S PHARMACY AND COSTUMES
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL FLINT JR. PHARMACY (PRESIDENT)
(608) 310-9922
Entity
Organization
Contact information
Practice address
3506 MONROE ST, MADISON, WI 53711-1703
(608) 238-3106
(608) 663-8074
Mailing address
3506 MONROE ST, MADISON, WI 53711-1703
(608) 238-3106
(608) 663-8074
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
7237-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112792
PK
—
05
—
33197000
—
WI
Enumeration date
07/22/2006
Last updated
05/18/2015
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