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
301 E 2ND ST, MERRILL, WI 54452-2317
(715) 536-2909
(715) 536-5094
Mailing address
555 S 72ND AVE, WAUSAU, WI 54401-9038
(715) 842-0370
(715) 842-0366
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
9172-42
WI
3336C0003X
Community/Retail Pharmacy
Primary
9172-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205164597
—
WI
Enumeration date
11/24/2009
Last updated
09/18/2014
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