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General NPI Number Information
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NPI Number | 1972648905
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Entity Type | Organization
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Legal Business Name | PICHELMEYERS INC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 320 WOLF RIVER PLZ
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City | NEW LONDON
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State | WI
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Zip | 54961-1237
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Country | US
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Telephone | 920-982-2401
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Fax | 920-982-2402
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Provider Business Mailing Address
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Address Line | 1900 MAYFLOWER CT
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City | NEW LONDON
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State | WI
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Zip | 54961-2431
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Country | US
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Telephone | 920-982-5432
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. IVER J RUDIE
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Credential | R.PH.
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Telephone | 920-982-2401
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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 | 6117-042
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License Number State | WI
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