Organization
BALLWEG FAMILY PHARMACY INC
Active
Parent organization
BALLWEG FAMILY PHARMACY, INC
Other names
BALLWEG FAMILY PHARMACY INC Long-Term Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
BALLWEG FAMILY PHARMACY, INC
Authorized official
DENNIS JOHN BALLWEG (PRESIDENT)
(608) 643-6500
Entity
Organization
Contact information
Practice address
1200 PRAIRIE ST, PRAIRIE DU SAC, WI 53578-2041
(608) 643-6500
Mailing address
1200 PRAIRIE ST, PRAIRIE DU SAC, WI 53578-2041
(608) 370-2396
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33282600
—
WI
Enumeration date
01/27/2023
Last updated
10/06/2023
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