Organization
DANICK INC
Active
Other names
29 SUPER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY PREGONT RPH (OWNER)
(715) 359-3194
Entity
Organization
Contact information
Practice address
2806 SCHOFIELD AVE, SCHOFIELD, WI 54476-2431
(715) 359-3194
(715) 359-7459
Mailing address
2806 SCHOFIELD AVE, SCHOFIELD, WI 54476-2431
(715) 359-3194
(715) 359-7459
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7434-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115411
PK
—
05
—
33204000
—
WI
Enumeration date
06/12/2006
Last updated
05/09/2016
Update your record
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