# RUSK COUNTY PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821415258
- **Authorized official:** JOSHUA J PROHASKA (OWNER)
- **Authorized official phone:** (715) 415-1891

## Contact information

- **Practice address:** 312 W 9TH ST N, LADYSMITH, WI 54848-1269
- **Practice address phone:** (715) 532-3339
- **Practice address fax:** (715) 532-3330
- **Mailing address:** 312 W 9TH ST N, LADYSMITH, WI 54848-1269
- **Mailing address phone:** (715) 532-3339
- **Mailing address fax:** (715) 532-3330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 9251-42 | WI | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/24/2014
- **Last updated:** 10/22/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10092-42 | WI STATE PHARMACY LICENSE | WI |