Healthcare Provider Details

I. General information

NPI: 1902962889
Provider Name (Legal Business Name): PHARMACARE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 BAY STREET
CHIPPEWA FALLS WI
54729-2491
US

IV. Provider business mailing address

212 BAY STREET
CHIPPEWA FALLS WI
54729-2491
US

V. Phone/Fax

Practice location:
  • Phone: 715-723-9177
  • Fax:
Mailing address:
  • Phone: 715-723-9177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY E LEVIN
Title or Position: PRESIDENT
Credential:
Phone: 715-833-6770