Healthcare Provider Details

I. General information

NPI: 1790879609
Provider Name (Legal Business Name): PHARMACY OPERATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SUPERIOR AVE
TOMAH WI
54660
US

IV. Provider business mailing address

1 RIDER TRAIL PLAZA DR SUITE 300
EARTH CITY MO
63045-1313
US

V. Phone/Fax

Practice location:
  • Phone: 608-372-2101
  • Fax:
Mailing address:
  • Phone: 314-993-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number8407042
License Number StateWI

VIII. Authorized Official

Name: MARK A MILLER
Title or Position: V.P. PHARMACY OPERATIONS
Credential:
Phone: 800-325-1397