Organization
PHARMACARE LTD
Active
Other names
Wally Shong Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDIN HENKE (CREDENTIALING)
(715) 833-6770
Entity
Organization
Contact information
Practice address
153 W LINCOLN ST, AUGUSTA, WI 54722-9152
(715) 286-2515
(715) 286-4102
Mailing address
PO BOX 364, AUGUSTA, WI 54722-0364
(715) 286-2515
(715) 286-4102
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33263400
—
WI
Enumeration date
09/02/2006
Last updated
05/11/2023
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