Whalio Doctors

NPI 1184784159

Thedacare Medical Center-Berlin INC

Organisation Community/Retail Pharmacy Wautoma, WI

Practice location

Address
N2934 Hwy 22 N, Wautoma, WI 54982-5267
Phone
(920) 787-5757
Fax
(920) 787-5382
Mailing address
N2934 Hwy 22 N, Wautoma, WI 54982

Authorised official

Name
Alissa Gies
Title
Pharmacist of Record
Phone
(920) 787-5757

Registered specialties (2)

Community/Retail Pharmacy Primary
Suppliers Taxonomy 3336C0003X Licence 7733-42 (WI)
Pharmacy
Suppliers Taxonomy 333600000X

Registry record

NPI
1184784159
Entity type
Organization
NPI issued
11 Dec 2006
Record last updated
18 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.