Organization
SERVICE DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JAMES HEBL RPH (PHARMACIST OWNER)
(608) 742-2808
Entity
Organization
Contact information
Practice address
130 W COOK, PORTAGE, WI 53901-2104
(608) 742-2808
Mailing address
130 W COOK, PORTAGE, WI 53901-2104
(608) 742-2808
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5463042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33111200
—
WI
Enumeration date
01/18/2007
Last updated
07/10/2008
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