Organization
MIKE FLINT ENTERPRISES INC
Active
Other names
MALLATT'S PHARMACY AND COSTUMES
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL FLINT JR. PHARMACY (PRESIDENT)
(608) 310-9922
Entity
Organization
Contact information
Practice address
3506 MONROE ST, MADISON, WI 53711-1703
(608) 238-3106
(608) 663-8074
Mailing address
3506 MONROE ST, MADISON, WI 53711-1703
(608) 238-3106
(608) 663-8074
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7237-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112792
PK
—
05
—
33197000
—
WI
Enumeration date
07/22/2006
Last updated
05/18/2015
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