Organization
JAT PHARMACY, LLC
Active
Other names
JAT Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A. BARTKOWIAK R.PH., MBA (DIRECTOR OF PHARMACY/PHARMACIST IN)
(877) 490-3577
Entity
Organization
Contact information
Practice address
805 BURTON BOULEVARD, SUITE A, DEFOREST, WI 53532
(877) 490-3577
(877) 490-3576
Mailing address
805 BURTON BOULEVARD, SUITE A, DEFOREST, WI 53532
(877) 490-3577
(877) 490-3576
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
9015-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125332
PK
—
Enumeration date
06/22/2010
Last updated
10/06/2023
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