Organization
BAY AREA MEDICAL CENTER INC
Active
Other names
BAY AREA OUTPATIENT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM F TACCOLINI (PHARMACY DIRECTOR)
(715) 735-6621
Entity
Organization
Contact information
Practice address
3100 SHORE DR-, SUITE COS, MARINETTE, WI 54143-4242
(715) 735-8072
(715) 735-8011
Mailing address
3100 SHORE DR-, SUITE COS, MARINETTE, WI 54143-4242
(715) 735-8072
(715) 735-8011
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8044-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33058800
—
WI
Enumeration date
08/24/2006
Last updated
04/08/2013
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