Organization
VILLAGE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DEAN HINES RPH (OWNER PRESIDENT)
(920) 897-5333
Entity
Organization
Contact information
Practice address
633 N HWY 141, BOX 186, COLEMAN, WI 54112-0186
(920) 897-5333
(920) 897-5451
Mailing address
633 N HWY 141, BOX 186, COLEMAN, WI 54112-0186
(920) 897-5333
(920) 897-5451
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8460
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33257500
—
WI
01
—
5126582
NCPDP
WI
Enumeration date
08/15/2006
Last updated
08/22/2020
Update your record
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