Organization
HO-CHUNK NATION
Active
Other names
HOUSE OF WELLNESS CENTER PHARMACY, House of Wellness Retail Pharmacy, Ho-Chunk House of Wellness Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WALLY L APLAND (HEALTH DEPT DIRECTOR OF FINANCE)
(715) 284-9851
Entity
Organization
Contact information
Practice address
S2845 WHITE EAGLE RD, BARABOO, WI 53913-9064
(608) 355-5177
(608) 356-1233
Mailing address
S2845 WHITE EAGLE RD, BARABOO, WI 53913-9064
(608) 355-1240
(608) 356-1233
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8332-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100052111
—
WI
01
—
2111110
PK
—
Enumeration date
06/02/2008
Last updated
04/06/2023
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