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Organization
ST CLARE MEMORIAL HOSPITAL INC
Active
Organization
ST CLARE MEMORIAL HOSPITAL INC
Active
Other names
HSHS St. Clare Memorial Hospital Pharmacy Gillett
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ALLEN (CFO)
(920) 884-5660
Entity
Organization
Contact information
Practice address
117 N MCKENZIE ST, GILLETT, WI 54124-9142
(920) 848-6323
(920) 848-8502
Mailing address
117 N MCKENZIE ST, PO BOX 558, GILLETT, WI 54124-9142
(920) 848-6323
(920) 848-8502
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9179-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000027937
—
WI
01
—
2138350
PK
—
Enumeration date
01/28/2013
Last updated
12/23/2021
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