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Organization
BADGER PHARMACY LLC
Active
Organization
BADGER PHARMACY LLC
Active
Other names
Young's Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FORREST YOUNG RPH (OWNER)
(715) 842-0370
Entity
Organization
Contact information
Practice address
555 S 72ND AVE, WAUSAU, WI 54401-9038
(715) 842-0791
(715) 845-2176
Mailing address
555 S 72ND AVE, WAUSAU, WI 54401-9038
(715) 842-0370
(715) 842-0366
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
9061-042
WI
3336L0003X
Long Term Care Pharmacy
Primary
9061-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609981653
—
WI
01
—
5128144
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/20/2006
Last updated
08/04/2014
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