Organization
WAUPACA WOODS PHARMACY INC.
Active
Other names
Riverside Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LEO OESTREICH RPH (PRESIDENT)
(715) 256-1115
Entity
Organization
Contact information
Practice address
800 RIVERSIDE DR, WAUPACA, WI 54981-1943
(715) 256-1115
(715) 256-1105
Mailing address
101 N WESTERN AVE, WAUPACA, WI 54981-2201
(715) 258-7621
(715) 258-6880
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
7739
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33228100
—
WI
Enumeration date
11/07/2006
Last updated
06/17/2008
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