Organization
BADGER PHARMACY LLC
Active
Other names
Young's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
FORREST YOUNG (OWNER)
(715) 842-0370
Entity
Organization
Contact information
Practice address
2106 GRAND AVE, WAUSAU, WI 54403-6912
(715) 845-3713
(715) 845-7957
Mailing address
555 S 72ND AVE, WAUSAU, WI 54401-9038
(715) 842-0370
(715) 842-0366
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8993-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124358940
—
WI
01
—
5132131
NCPDP
—
Enumeration date
12/29/2009
Last updated
08/05/2014
Update your record
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