Organization
THEDA CLARK PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-3090
Mailing address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-3090
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
3273
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33175500
—
WI
Enumeration date
03/14/2007
Last updated
01/02/2024
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