Organization
JACK A BESANT INC
Active
Other names
FOX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JACK BESANT (PRESIDENT)
(608) 462-8261
Entity
Organization
Contact information
Practice address
130 MAIN ST, ELROY, WI 53929-1250
(608) 462-8261
(608) 462-8262
Mailing address
130 MAIN ST, ELROY, WI 53929-1250
(608) 462-8261
(608) 462-8262
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5937-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33004800
—
WI
01
—
5113206
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/31/2006
Last updated
05/20/2010
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