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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