Organization
VERNON MEMORIAL HEALTHCARE INC
Active
Parent organization
VERNON MEMORIAL HEALTHCARE, INC.
Other names
VERNON MEMORIAL PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
VERNON MEMORIAL HEALTHCARE, INC.
Authorized official
DAVID HARTBERG (CEO)
(608) 637-4796
Entity
Organization
Contact information
Practice address
407 S MAIN ST, SUITE 104, VIROQUA, WI 54665-2100
(608) 637-4718
(608) 637-4719
Mailing address
407 S MAIN ST, SUITE 104, VIROQUA, WI 54665-2100
(608) 637-4716
(608) 637-4719
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8572-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110890
PK
—
05
—
33289200
—
WI
Enumeration date
06/05/2006
Last updated
01/07/2020
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