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Organization
MICKLESEN DRUG INC
Active
Organization
MICKLESEN DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK C ANDERSON RPH PHARMACIST IN CH (PRESIDENT)
(715) 386-3344
Entity
Organization
Contact information
Practice address
530 SECOND ST, HUDSON, WI 54016
(715) 386-3344
(715) 386-5198
Mailing address
530 SECOND ST, HUDSON, WI 54016
(715) 386-3344
(715) 386-5198
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4862042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33003000
—
WI
01
—
5106275
NAPB
—
Enumeration date
11/01/2006
Last updated
03/07/2023
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