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Organization
MIRAVIDA LIVING INC
Active
Organization
MIRAVIDA LIVING INC
Active
Other names
LHO PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI L SCHUELER PHARMD (DIRECTOR OF PHARMACY)
(920) 966-1345
Entity
Organization
Contact information
Practice address
225 N EAGLE ST, OSHKOSH, WI 54902-4125
(920) 966-1345
(920) 966-1285
Mailing address
225 N EAGLE ST, OSHKOSH, WI 54902-4125
(920) 966-1345
(920) 966-1285
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
827342
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110060
PK
—
05
—
33267400
—
WI
Enumeration date
10/06/2005
Last updated
08/12/2026
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