Organization
ST CLARE MEMORIAL HOSPITAL INC
Active
Other names
HSHS St. Clare Memorial Hospital Pharmacy Gillett
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ALLEN (CFO)
(920) 884-5660
Entity
Organization
Contact information
Practice address
117 N MCKENZIE ST, GILLETT, WI 54124-9142
(920) 848-6323
(920) 848-8502
Mailing address
117 N MCKENZIE ST, PO BOX 558, GILLETT, WI 54124-9142
(920) 848-6323
(920) 848-8502
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9179-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000027937
—
WI
01
—
2138350
PK
—
Enumeration date
01/28/2013
Last updated
12/23/2021
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