Organization
MEGS PHARMACY INC
Active
Other names
CRIVITZ PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EZRA GRUSZYNSKI PHARMD (OWNER PRESIDENT)
(715) 854-7425
Entity
Organization
Contact information
Practice address
710 MAIN AVE, CRIVITZ, WI 54114-1664
(715) 854-7425
(715) 854-7326
Mailing address
PO BOX 488, CRIVITZ, WI 54114-0488
(715) 854-7425
(715) 854-7326
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
852742
WI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2114513
PK
—
05
—
33285100
—
WI
Enumeration date
03/16/2006
Last updated
02/20/2017
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