Organization
WAARVIK DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEROLD R GRASSMAN RPH (OWNER/PRESIDENT/PHARMACIST)
(715) 284-4354
Entity
Organization
Contact information
Practice address
109 MAIN ST, BLACK RIVER FALLS, WI 54615-1748
(715) 284-4354
(715) 284-9053
Mailing address
109 MAIN ST, BLACK RIVER FALLS, WI 54615-1748
(715) 284-4354
(715) 284-9053
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
7290042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33095500
—
WI
Enumeration date
10/23/2006
Last updated
05/03/2010
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