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Organization

JERRYS ENTERPRISES INC

Active
Other names
COUNTY MARKET PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH HOEHN RPH (PHARMACY MANAGER)
(715) 218-3925
Entity
Organization

Contact information

Practice address
220 S 18TH AVE, WAUSAU, WI 54401-4252
(715) 842-3541
(715) 845-5306
Mailing address
220 S 18TH AVE, WAUSAU, WI 54401-4252
(715) 842-3541
(715) 845-5306

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
8362042
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2113198
PK
05
33271600
WI
Enumeration date
08/18/2006
Last updated
11/24/2020
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