Organization
NICOLET PHARMACY LONG TERM CARE
Active
Parent organization
NICOLET PHARMACY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NICOLET PHARMACY INC
Authorized official
AMY J DONALDSON (PRESIDENT)
(715) 276-3646
Entity
Organization
Contact information
Practice address
15481 COMMERCIAL RD STE A, LAKEWOOD, WI 54138-9677
(715) 276-3646
(715) 276-9568
Mailing address
15481 COMMERCIAL RD STE A, LAKEWOOD, WI 54138-9677
(715) 276-3646
(715) 276-9568
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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