Organization
SKJ INC.
Active
Other names
DOOR CREEK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN HOEY (OWNER)
(608) 839-3784
Entity
Organization
Contact information
Practice address
50 N MAIN ST, DEERFIELD, WI 53531-9353
(608) 764-8111
(608) 764-5556
Mailing address
431 W COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9385
(608) 839-3784
(608) 839-3786
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
838342
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33274500
—
WI
01
—
5127813
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/30/2007
Last updated
09/22/2011
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