# GWIDT PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558092429
- **Authorized official:** DR. SHANE RESCH PHARM D, RPH (VICE-PRESIDENT)
- **Authorized official phone:** (715) 253-2164

## Contact information

- **Practice address:** 203 E WESTGOR AVE, WITTENBERG, WI 54499-9174
- **Practice address phone:** (715) 253-2164
- **Practice address fax:** (715) 253-3030
- **Mailing address:** PO BOX 253, WITTENBERG, WI 54499-0253
- **Mailing address phone:** (715) 253-2164
- **Mailing address fax:** (715) 253-3030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/22/2022
- **Last updated:** 06/22/2022