Organization
MANITOWOC PHARMACIES INC
Active
Other names
Health Mart Manitowoc Pharmacies
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE RESCH (PRESIDENT)
(715) 253-2164
Entity
Organization
Contact information
Practice address
919 S 8TH ST, MANITOWOC, WI 54220-4504
(920) 684-6789
(920) 684-7041
Mailing address
919 S 8TH ST, MANITOWOC, WI 54220-4504
(920) 684-6789
(920) 684-7041
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4907-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134084
PK
—
05
—
33097000
—
WI
Enumeration date
08/10/2006
Last updated
12/20/2023
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