Organization
BROWNSTONE RX
Active
Other names
Langford Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DELORA PUFALL (PIC/OWNER)
(715) 373-5588
Entity
Organization
Contact information
Practice address
114 WEST BAYFIELD STREET, WASHBURN, WI 54891
(715) 373-5588
(715) 373-0481
Mailing address
PO BOX 40, WASHBURN, WI 54891-0040
(715) 373-5588
(715) 373-0481
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
7456-042
WI
3336C0003X
Community/Retail Pharmacy
Primary
9451-42
WI
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113837
PK
—
05
—
33016300
—
WI
01
—
5113472
NCPDP PROVIDER ID
—
Enumeration date
12/11/2006
Last updated
12/27/2017
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