Organization
CORCORAN HEALTHCARE ENT INC
Active
Other names
Richland Family Prescription Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL F CORCORAN RPH (OWNER)
(608) 647-8806
Entity
Organization
Contact information
Practice address
301 E 2ND ST, RICHLAND CENTER, WI 53581-1900
(608) 647-8806
(608) 647-2029
Mailing address
301 E 2ND ST, PO BOX 309, RICHLAND CENTER, WI 53581-1900
(608) 647-8806
(608) 647-2029
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
7973-042
WI
3336L0003X
Long Term Care Pharmacy
7973-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33168200
—
WI
01
—
B08230661
CEDI TRADING PARTNER
WI
Enumeration date
10/26/2016
Last updated
11/10/2016
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