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General NPI Number Information
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NPI Number | 1316789878
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Entity Type | Organization
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Legal Business Name | ELKHORN PHARMACY LTD
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 603 E GENEVA ST
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City | ELKHORN
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State | WI
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Zip | 53121-2301
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Country | US
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Telephone | 262-723-8444
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Fax | 262-723-8760
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Provider Business Mailing Address
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Address Line | 603 E GENEVA ST
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City | ELKHORN
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State | WI
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Zip | 53121-2301
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Country | US
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Telephone | 262-723-8444
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Fax | 262-723-8760
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Authorized Official
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Title or Position | OWNER
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Name | MAY HERNING KUE
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Credential | PHARMD
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Telephone | 262-723-8444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care 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 | 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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