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Organization

MORTON DRUG CO INC

Active
Other names
MORTON PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY BLANK (VP CORPORATE SERVICES)
(920) 727-8882
Entity
Organization

Contact information

Practice address
102 S SIDE SHOPPING CTR, CHILTON, WI 53014-1615
(920) 849-9313
(920) 849-4062
Mailing address
PO BOX 778, NEENAH, WI 54957-0778
(920) 727-3853
(920) 727-3867

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
8764042
WI
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1740221530
WI
01
5110793
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
06/10/2006
Last updated
09/08/2010
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