Organization Name: | KAUKAUNA PRESCRIPTION CENTER |
NPI Number: | 1376615575 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEROME WALLENFANG (OWNER AND CEO) |
Mailing Address: | 200 E 2nd St Kaukauna |
State: | WI US |
Postal Code: | 541302524 |
Phone Number: | 9207669200 |
Fax Number: | 9207667998 |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | 8079042 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WI |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |