Organization
RUSK COUNTY PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA J PROHASKA (OWNER)
(715) 415-1891
Entity
Organization
Contact information
Practice address
312 W 9TH ST N, LADYSMITH, WI 54848-1269
(715) 532-3339
(715) 532-3330
Mailing address
312 W 9TH ST N, LADYSMITH, WI 54848-1269
(715) 532-3339
(715) 532-3330
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9251-42
WI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10092-42
WI STATE PHARMACY LICENSE
WI
Enumeration date
03/24/2014
Last updated
10/22/2024
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