# MIKE FLINT ENTERPRISES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mallatt's Pharmacy and Costume \#101
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679575476
- **Authorized official:** JOHN MICHAEL FLINT JR. (PRESIDENT)
- **Authorized official phone:** (608) 310-9922

## Contact information

- **Practice address:** 1255 WILLIAMSON ST, MADISON, WI 53703-3754
- **Practice address phone:** (608) 255-9116
- **Practice address fax:** (608) 255-9969
- **Mailing address:** 1255 WILLIAMSON ST, MADISON, WI 53703-3754
- **Mailing address phone:** (608) 255-9116
- **Mailing address fax:** (608) 255-9969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 9024-42 | WI | Yes |

## Other

- **Enumeration date:** 08/11/2005
- **Last updated:** 05/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2126885 | PK | — |
| 05 | — | 33074800 | — | WI |