Organization
SOUTHWEST HEALTH CENTER INC
Active
Other names
The Pharmacy at Southwest Health
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE SOOKOCHOFF (CHIEF FINANCIAL OFFICER)
(608) 348-2331
Entity
Organization
Contact information
Practice address
1450 EASTSIDE RD, PLATTEVILLE, WI 53818-9800
(608) 342-6200
(608) 342-6299
Mailing address
1450 EASTSIDE RD, PLATTEVILLE, WI 53818-9800
(608) 342-6200
(608) 342-6299
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9329-42
WI
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048849
—
WI
01
—
2152790
PK
—
Enumeration date
05/20/2015
Last updated
12/17/2021
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