# BALLWEG FAMILY PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BALLWEG FAMILY PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710916416
- **Authorized official:** DENNIS BALLWEG RPH (OWNER AND PHARMACIST)
- **Authorized official phone:** (608) 643-6500

## Contact information

- **Practice address:** 1200 PRAIRIE ST, PRAIRIE DU SAC, WI 53578-2041
- **Practice address phone:** (608) 643-6500
- **Practice address fax:** (608) 643-6533
- **Mailing address:** 1200 PRAIRIE ST, PRAIRIE DU SAC, WI 53578-2041
- **Mailing address phone:** (608) 643-6500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 8489-42 | WI | Yes |

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 10/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2110297 | PK | — |