# IN THE WOODS APOTHECARY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Siren Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659770113
- **Authorized official:** JOHN PETERSON (OWNER)
- **Authorized official phone:** (715) 349-2221

## Contact information

- **Practice address:** 24106 STATE RD 35, SIREN, WI 54872
- **Practice address phone:** (715) 349-2221
- **Practice address fax:** (855) 848-0828
- **Mailing address:** PO BOX 503, SIREN, WI 54872-0503
- **Mailing address phone:** (715) 349-2221
- **Mailing address fax:** (715) 349-7350

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9275-42 | WI | Yes |

## Other

- **Enumeration date:** 08/20/2014
- **Last updated:** 10/20/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1659770113 | — | WI |
| 01 | — | 2147456 | PK | — |