Healthcare Provider Details

I. General information

NPI: 1649212945
Provider Name (Legal Business Name): DANICK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2806 SCHOFIELD AVE
SCHOFIELD WI
54476-2431
US

IV. Provider business mailing address

2806 SCHOFIELD AVE
SCHOFIELD WI
54476-2431
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-3194
  • Fax: 715-359-7459
Mailing address:
  • Phone: 715-359-3194
  • Fax: 715-359-7459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number7434-42
License Number StateWI

VIII. Authorized Official

Name: SALLY PREGONT
Title or Position: OWNER
Credential: RPH
Phone: 715-359-3194