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General NPI Number Information
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NPI Number | 1053645986
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Entity Type | Organization
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Legal Business Name | MORTON DRUG CO INC
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 2500 E CAPITOL DR STE 1500
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City | APPLETON
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State | WI
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Zip | 54911-8735
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Country | US
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Telephone | 920-882-6333
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Fax | 920-882-6633
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Provider Business Mailing Address
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Address Line | 2500 E CAPITOL DR
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City | APPLETON
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State | WI
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Zip | 54911-8735
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Country | US
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Telephone | 920-882-6333
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Fax | 920-882-6633
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Authorized Official
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Title or Position | V.P. OPERATIONS
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Name | DAVID MORTON
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Credential | RPH
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Telephone | 920-882-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 8948-042
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License Number State | WI
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