Organization
BELLICOSE INTERNATIONAL INC.
Active
Other names
Wood River Pharmacy Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER JOHN WITZANY R.PH. (MANAGER)
(715) 463-2525
Entity
Organization
Contact information
Practice address
122 W MADISON AVE, GRANTSBURG, WI 54840-7022
(715) 463-2525
(715) 463-5343
Mailing address
PO BOX 39, GRANTSBURG, WI 54840-0039
(715) 463-2525
(715) 463-5343
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33154200
—
WI
Enumeration date
05/21/2019
Last updated
09/25/2023
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