Organization
SAINT-MARK ENTERPRISES 1798 LLC
Active
Other names
THE MEDICINE SHOPPE 1798
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MILLER (OFFICER / MANAGING PARTNER)
(314) 518-2427
Entity
Organization
Contact information
Practice address
300 SUPERIOR AVENUE, TOMAH, WI 54660
(608) 372-2101
Mailing address
PO BOX 98, EUREKA, MO 63025-0098
(314) 518-2427
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002221
—
WI
01
—
5131355
NCPDP #
—
Enumeration date
01/08/2009
Last updated
01/29/2024
Update your record
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