Organization
LYNJA INC
Active
Other names
Daly Drug Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASON GRUSZYNSKI (PRESIDENT)
(715) 423-3400
Entity
Organization
Contact information
Practice address
3215 8TH ST S STE 101, WISCONSIN RAPIDS, WI 54494-6564
(715) 423-3401
(715) 432-5523
Mailing address
3215 8TH ST S STE 101, WISCONSIN RAPIDS, WI 54494-6564
(715) 423-3401
(715) 432-5523
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
9350-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100049507
—
WI
01
—
2154142
PK
—
Enumeration date
09/15/2015
Last updated
02/28/2017
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