Organization
BENZER WI 2 LLC
Active
Other names
Peshtigo Pharmacy, Peshtigo Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BHARGAVI PATEL (OWNER)
(810) 348-3003
Entity
Organization
Contact information
Practice address
220 FRENCH ST, PESHTIGO, WI 54157-1218
(715) 582-4237
(715) 582-0213
Mailing address
220 FRENCH STREET, PESHTIGO, WI 54157
(813) 304-2221
(888) 239-8423
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
9304-42
WI
3336C0003X
Community/Retail Pharmacy
Primary
9491-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151000
PK
—
05
—
33094900
—
WI
Enumeration date
06/01/2005
Last updated
10/25/2022
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