Organization
BENZER WI 1 LLC
Active
Organization
BENZER WI 1 LLC
Active
Other names
Oconto Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BHARGAVI PATEL (OWNER)
(810) 348-3003
Entity
Organization
Contact information
Practice address
1008 MAIN ST, OCONTO, WI 54153
(920) 834-4455
(920) 834-3655
Mailing address
1008 MAIN STREET, OCONTO, WI 54153
(813) 304-2221
(888) 239-8423
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9302-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151001
PK
—
05
—
33009500
—
WI
Enumeration date
10/28/2005
Last updated
05/13/2021
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