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Organization
JERRYS ENTERPRISES INC
Active
Organization
JERRYS ENTERPRISES INC
Active
Other names
COUNTY MARKET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH HOEHN RPH (PHARMACY MANAGER)
(715) 218-3925
Entity
Organization
Contact information
Practice address
220 S 18TH AVE, WAUSAU, WI 54401-4252
(715) 842-3541
(715) 845-5306
Mailing address
220 S 18TH AVE, WAUSAU, WI 54401-4252
(715) 842-3541
(715) 845-5306
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
8362042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113198
PK
—
05
—
33271600
—
WI
Enumeration date
08/18/2006
Last updated
11/24/2020
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