# GWIDT PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GWIDT PHARMACY INC
- **Other names:** Oconto Falls Pharmacy - LongTerm Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922738970
- **Legal business name:** GWIDT PHARMACY INC
- **Authorized official:** MR. TIMOTHY P STARRY (PRESIDENT)
- **Authorized official phone:** (920) 848-3721

## Contact information

- **Practice address:** 323 E HIGHLAND DR, OCONTO FALLS, WI 54154-1006
- **Practice address phone:** (920) 848-3721
- **Mailing address:** PO BOX 129, OCONTO FALLS, WI 54154-0129
- **Mailing address phone:** (920) 848-3721
- **Mailing address fax:** (920) 848-4374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/13/2022
- **Last updated:** 06/13/2022