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Organization
WAUPACA WOODS PHARMACY INC.
Active
Organization
WAUPACA WOODS PHARMACY INC.
Active
Other names
Riverside Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LEO OESTREICH RPH (PRESIDENT)
(715) 256-1115
Entity
Organization
Contact information
Practice address
800 RIVERSIDE DR, WAUPACA, WI 54981-1943
(715) 256-1115
(715) 256-1105
Mailing address
101 N WESTERN AVE, WAUPACA, WI 54981-2201
(715) 258-7621
(715) 258-6880
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
7739
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33228100
—
WI
Enumeration date
11/07/2006
Last updated
06/17/2008
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