Organization
IN THE WOODS APOTHECARY
Active
Other names
Siren Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PETERSON (OWNER)
(715) 349-2221
Entity
Organization
Contact information
Practice address
24106 STATE RD 35, SIREN, WI 54872
(715) 349-2221
(855) 848-0828
Mailing address
PO BOX 503, SIREN, WI 54872-0503
(715) 349-2221
(715) 349-7350
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9275-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659770113
—
WI
01
—
2147456
PK
—
Enumeration date
08/20/2014
Last updated
10/20/2022
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