Organization
KAUKAUNA PRESCRIPTION CENTER
Active
Other names
CONSUMER PRESCRIPTION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME WALLENFANG RPH (OWNER AND CEO)
(920) 766-9200
Entity
Organization
Contact information
Practice address
200 E 2ND ST, KAUKAUNA, WI 54130-2524
(920) 766-9200
(920) 766-7998
Mailing address
200 E 2ND ST, KAUKAUNA, WI 54130-2524
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
8079042
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33127100
—
WI
01
—
5112393
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/14/2006
Last updated
09/11/2025
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