| Organization Name: | PARK PHARMACY INC |
| NPI Number: | 1316940679 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK PECHACEK (OWNER) |
| Mailing Address: | 138 1/2 2nd Ave N Park Falls |
| State: | WI US |
| Postal Code: | 545521214 |
| Phone Number: | 7157623248 |
| Fax Number: | 7157622980 |
| NPI Enumeration Date: | 05/31/2005 |
| NPI Last Update Date: | 05/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | 7643-042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |