Organization
HAWKEYE ENTERPRISES LLC
Active
Other names
Olsen & Son Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS W MOORE R.PH. (OWNER)
(715) 349-2221
Entity
Organization
Contact information
Practice address
24106 STATE ROAD 35, SIREN, WI 54872-0000
(715) 349-2221
(715) 349-7350
Mailing address
24106 STATE ROAD 35, SIREN, WI 54872
(715) 349-2221
(715) 349-7350
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8102-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33259100
—
WI
05
—
41725000
—
WI
01
—
5116024
NCPDP
WI
Enumeration date
10/17/2006
Last updated
04/08/2008
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