NPI 1548529332

Good Harvest Market

Organisation Medical Foods Supplier Pewaukee, WI

Practice location

Address: 1850 Meadow Ln, Pewaukee, WI 53072-5572
Phone: (262) 544-9380
Mailing address: 1850 Meadow Lane, Pewaukee, WI 53072

Authorised official

Name: Becky Famularo
Title: Bookkeeper
Phone: (262) 544-9380

Registered specialties

Medical Foods Supplier Primary

Suppliers Taxonomy 335G00000X

Other Medical Foods Supplier providers in Wisconsin →

Registry record

NPI: 1548529332
Entity type: Organization
NPI issued: 14 May 2012
Record last updated: 14 May 2012

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.