Organization
BADGER PHARMACY LLC
Active
Other names
Young's Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FORREST YOUNG RPH (OWNER)
(715) 842-0370
Entity
Organization
Contact information
Practice address
555 S 72ND AVE, WAUSAU, WI 54401-9038
(715) 842-0791
(715) 845-2176
Mailing address
555 S 72ND AVE, WAUSAU, WI 54401-9038
(715) 842-0370
(715) 842-0366
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
9061-042
WI
3336L0003X
Long Term Care Pharmacy
Primary
9061-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609981653
—
WI
01
—
5128144
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/20/2006
Last updated
08/04/2014
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