Organization
RIVER VALLEY PHARMACY INC
Active
Other names
RIVER VALLEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DALE PERSZYK (MANAGER)
(715) 483-0426
Entity
Organization
Contact information
Practice address
208 S ADAMS ST, SAINT CROIX FALLS, WI 54024-9449
(715) 483-0426
Mailing address
208 S ADAMS ST, SAINT CROIX FALLS, WI 54024-9449
(715) 483-0426
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7931042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33069300
—
WI
01
—
5118509
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/31/2006
Last updated
03/26/2012
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