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Organization
SPRING GREEN PHARMACY INC
Active
Organization
SPRING GREEN PHARMACY INC
Active
Other names
Spring Green Health Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHA HAHN (CO OWNER AND VP)
(608) 588-2541
Entity
Organization
Contact information
Practice address
208 E JEFFERSON ST, SPRING GREEN, WI 53588-8002
(608) 588-2541
(608) 588-2884
Mailing address
PO BOX 69, SPRING GREEN, WI 53588-0069
(608) 588-2541
(608) 588-2884
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
6137-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168271
PK
—
05
—
33122100
—
WI
Enumeration date
03/24/2017
Last updated
03/24/2017
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