Organization
MIKE FLINT ENTERPRISES INC
Active
Other names
Mallatt's Pharmacy and Costume #101
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL FLINT JR. (PRESIDENT)
(608) 310-9922
Entity
Organization
Contact information
Practice address
1255 WILLIAMSON ST, MADISON, WI 53703-3754
(608) 255-9116
(608) 255-9969
Mailing address
1255 WILLIAMSON ST, MADISON, WI 53703-3754
(608) 255-9116
(608) 255-9969
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9024-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126885
PK
—
05
—
33074800
—
WI
Enumeration date
08/11/2005
Last updated
05/18/2015
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