Organization
NUTRITIONAL DESIGNS LLC
Active
Other names
NUTRITIONAL DESIGNS AND PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JODY MUNIZ (OWNER)
(262) 632-6500
Entity
Organization
Contact information
Practice address
5220 WASHINGTON AVE STE 101, RACINE, WI 53406-4228
(262) 632-6500
(262) 632-6505
Mailing address
5220 WASHINGTON AVE, SUITE 101, RACINE, WI 53406-4228
(262) 632-6500
(262) 632-6505
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9184-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110287
PK
—
05
—
33281600
—
WI
Enumeration date
08/31/2006
Last updated
07/14/2016
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