Healthcare Provider Details

I. General information

NPI: 1699840033
Provider Name (Legal Business Name): MORTON DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E BELL ST
NEENAH WI
54956-5096
US

IV. Provider business mailing address

PO BOX 778
NEENAH WI
54957-0778
US

V. Phone/Fax

Practice location:
  • Phone: 920-727-3853
  • Fax: 920-722-1530
Mailing address:
  • Phone: 920-727-3853
  • Fax: 920-727-3867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number9299-42
License Number StateWI

VIII. Authorized Official

Name: JEFFREY BLANK
Title or Position: VP CORPORATE SERVICES
Credential:
Phone: 920-727-8882