Organization
AMERY REGIONAL MEDICAL CENTER, INC
Active
Other names
Amery Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA ANNELFSTROM RUDQUIST (CEO/PRESIDENT)
(715) 268-0300
Entity
Organization
Contact information
Practice address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-0678
(715) 268-0679
Mailing address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-0678
(715) 268-0679
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9660-42
WI BOARD PHARMACY LICENSE
WI
Enumeration date
02/04/2021
Last updated
02/04/2021
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