Organization
CARL JEFFREY ELIASON
Active
Other names
Peoples Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL JEFF ELIASON PHARMACIST (OWNER PHARMACIST)
(715) 394-7765
Entity
Organization
Contact information
Practice address
1124 BELKNAP ST, SUPERIOR, WI 54880-2856
(715) 394-7765
(715) 394-7765
Mailing address
1124 BELKNAP ST, SUPERIOR, WI 54880-2856
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10055040
WI
332BC3200X
Customized Equipment (DME)
—
—
333600000X
Pharmacy
7047042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33075100
—
WI
Enumeration date
03/13/2007
Last updated
09/05/2008
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