Organization
MARSHLAND PHARMACIES INC
Active
Other names
MARSHLAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SUTTER (CO OWNER/PHARM MGR)
(920) 356-0040
Entity
Organization
Contact information
Practice address
705 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3053
(920) 356-0040
(920) 356-0056
Mailing address
705 S UNIVERSITY AVE, SUITE 180, BEAVER DAM, WI 53916-3053
(920) 356-0040
(920) 356-0056
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8546042
WI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110854
PK
—
05
—
33287900
—
WI
Enumeration date
07/30/2006
Last updated
09/15/2014
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