Organization
ROCKMED LLC
Active
Other names
Rockmed Long Term Care Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC GRESENS (OWNER)
(608) 884-6644
Entity
Organization
Contact information
Practice address
711 N MAIN ST, EDGERTON, WI 53534-1530
(608) 884-6644
(855) 523-0916
Mailing address
711 N MAIN ST, EDGERTON, WI 53534-1530
(608) 884-6644
(855) 523-0916
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
9178-042
WI
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750527792
—
WI
01
—
2118330
PK
—
01
—
K300100832
PTAN
WI
Enumeration date
12/22/2008
Last updated
09/24/2020
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