Organization
SPRING GREEN PHARMACY INC
Active
Other names
Spring Green Health Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHA HAHN (CO OWNER AND VP)
(608) 588-2541
Entity
Organization
Contact information
Practice address
208 E JEFFERSON ST, SPRING GREEN, WI 53588-8002
(608) 588-2541
(608) 588-2884
Mailing address
PO BOX 69, SPRING GREEN, WI 53588-0069
(608) 588-2541
(608) 588-2884
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
6137-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168271
PK
—
05
—
33122100
—
WI
Enumeration date
03/24/2017
Last updated
03/24/2017
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