Organization
L & P NYBERG LLC
Active
Other names
Durand Fresh Market
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP NYBERG (OWNER)
(651) 380-9061
Entity
Organization
Contact information
Practice address
520 W MAIN ST, DURAND, WI 54736-1065
(715) 672-5900
(715) 672-5908
Mailing address
520 W MAIN ST, DURAND, WI 54736-1065
(715) 672-5900
(715) 672-5908
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
6151
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33018900
—
WI
01
—
5114905
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/05/2007
Last updated
09/12/2018
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