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Organization

MAG RX LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CASEY J BLOM PHARMD (MANAGER)
(920) 897-5333
Entity
Organization

Contact information

Practice address
633 BUSINESS 141 N, COLEMAN, WI 54112-9416
(920) 897-5333
(920) 897-5451
Mailing address
633 BUSINESS 141 N, COLEMAN, WI 54112-9416
(920) 897-5333
(920) 897-5451

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
9511-42
WI

Other

Enumeration date
05/09/2018
Last updated
04/27/2020
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