Organization
MORTON DRUG CO INC
Active
Other names
MORTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY BLANK (VP CORPORATE SERVICES)
(920) 727-8882
Entity
Organization
Contact information
Practice address
N162 EISENHOWER DR, SUITE 100, APPLETON, WI 54915-6171
(920) 731-4830
(920) 731-4709
Mailing address
PO BOX 778, NEENAH, WI 54957-0778
(920) 727-3853
(920) 727-3867
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8535
WI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33286500
—
WI
01
—
5104803
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/07/2006
Last updated
09/08/2010
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