Organization
LYNJA INC
Active
Other names
Daly Drug
Organization subpart
No
Provider details
NPI number
Authorized official
JASON GRUSZYNSKI R.PH. (PRESIDENT)
(715) 423-3400
Entity
Organization
Contact information
Practice address
3215 8TH ST S, WISCONSIN RAPIDS, WI 54494-6564
(715) 423-3400
(715) 423-5504
Mailing address
3215 8TH ST S, WISCONSIN RAPIDS, WI 54494-6564
(715) 423-3400
(715) 423-5504
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
9165-42
WI
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138264
PK
—
Enumeration date
10/17/2012
Last updated
01/18/2017
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