MEDICARE: DALY DRUG, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	6119	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518950872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALY DRUG, INC.

Provider Business Mailing Address
First Line	:	3215 8TH ST S
Second Line	:
City	:	WISCONSIN RAPIDS
State	:	WI
Zip	:	54494-6564
Country	:	US
Telephone Number	:	715-423-3400
Fax Number	:	715-423-5504

Provider Business Practice Location Address
First Line	:	3215 8TH ST S
Second Line	:
City	:	WISCONSIN RAPIDS
State	:	WI
Zip	:	54494-6564
Country	:	US
Telephone Number	:	715-423-3400
Fax Number	:	715-423-5504

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PAUL L. NELSON
Credential	:	R.PH.
Telephone Number	:	715-423-3400

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	08/22/2020

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