Organization
AGNESIAN HEALTHCARE ENTERPRISES LLC
Active
Other names
Agnesian Pharmacy Waupun
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SPENCER (SYSTEM VP PHARMACY SERVICES)
(920) 926-6011
Entity
Organization
Contact information
Practice address
904 W MAIN ST, WAUPUN, WI 53963-1201
(920) 324-8703
(920) 324-3476
Mailing address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
(920) 926-6010
(920) 926-6046
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33272300
—
WI
Enumeration date
05/14/2020
Last updated
06/07/2023
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