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Organization
RIVER VALLEY PHARMACY INC
Active
Organization
RIVER VALLEY PHARMACY INC
Active
Other names
RIVER VALLEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DALE PERSZYK (MANAGER)
(715) 483-0426
Entity
Organization
Contact information
Practice address
208 S ADAMS ST, SAINT CROIX FALLS, WI 54024-9449
(715) 483-0426
Mailing address
208 S ADAMS ST, SAINT CROIX FALLS, WI 54024-9449
(715) 483-0426
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
7931042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33069300
—
WI
01
—
5118509
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/31/2006
Last updated
03/26/2012
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