Organization
PRESCRIPTION CENTER PHARMACY
Active
Other names
PRESCRIPTION CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID EICHSTAEDT (OWNER)
(262) 567-7267
Entity
Organization
Contact information
Practice address
888 THACKERAY TRL, STE 101, OCONOMOWOC, WI 53066-4342
(262) 567-7267
(262) 567-7244
Mailing address
888 THACKERAY TRL, STE 101, OCONOMOWOC, WI 53066-4342
(262) 567-7267
(262) 567-7244
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
789742
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113840
PK
—
05
—
33053200
—
WI
Enumeration date
11/21/2006
Last updated
02/20/2017
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