Organization
WEST SALEM PHARMACY LLC
Active
Other names
WEST SALEM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BRIESKE (PHARMACY MGR)
(608) 786-0210
Entity
Organization
Contact information
Practice address
880 MILL ST N, WEST SALEM, WI 54669-2213
(608) 786-0210
(608) 786-0211
Mailing address
PO BOX 185, WEST SALEM, WI 54669-0185
(608) 786-0210
(608) 786-0211
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9004-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111878
PK
—
05
—
33287600
—
WI
Enumeration date
05/09/2006
Last updated
08/09/2016
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