Organization
RESTORE HEALTH PHARMACY, LLC
Active
Other names
Restore Health Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW WANDERER PHARMD (CEO)
(480) 421-8005
Entity
Organization
Contact information
Practice address
1289 DEMING WAY, MADISON, WI 53717-2007
(800) 558-7046
(888) 898-7412
Mailing address
1289 DEMING WAY, MADISON, WI 53717-2007
(800) 558-7046
(888) 898-7412
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9070-042
WI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130190
PK
—
Enumeration date
05/06/2011
Last updated
02/23/2015
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