Healthcare Provider Details

I. General information

NPI: 1861590853
Provider Name (Legal Business Name): JAMES PHARMACY - TURTLE LAKE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 MAPLE ST S
TURTLE LAKE WI
54889-8003
US

IV. Provider business mailing address

PO BOX 46
TURTLE LAKE WI
54889-0046
US

V. Phone/Fax

Practice location:
  • Phone: 715-986-2225
  • Fax: 715-986-4079
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number684542
License Number StateWI

VIII. Authorized Official

Name: PAIGE WILES
Title or Position: ADMIN ASSISTANT
Credential:
Phone: 715-418-3478