Organization
JEWEL FOOD STORES INC
Active
Other names
OSCO DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
N112 W 15800 MEQUON RD, GERMANTOWN, WI 53022
(262) 253-1526
(262) 253-2793
Mailing address
N112 W 15800 MEQUON RD, GERMANTOWN, WI 53022
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
8076
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33255800
—
WI
01
—
5126431
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
05/26/2006
Last updated
09/11/2025
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