Organization
COMMUNITY HEALTH PHARMACY LLC
Active
Other names
Community Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS A BRIESKE (OWNER)
(608) 386-9039
Entity
Organization
Contact information
Practice address
880 N. MILL ST., SUITE 101, WEST SALEM, WI 54669
(608) 786-2520
Mailing address
P.O. BOX 185, WEST SALEM, WI 54669
(608) 786-2520
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
9003-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073839114
—
WI
Enumeration date
04/14/2010
Last updated
08/09/2016
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