Peggy Ann Prohaska, RPH

Individual provider Active NPI Pharmacist · Park Falls, WI

NPI 1013194992 · NPPES record last updated Jan 23, 2008

Key facts

NPI
1013194992
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
8107 (WI)
Practice address
138 2ND Ave N
Park Falls, WI 54552-1214
Phone
(715) 762-3283
Fax
(715) 762-2980
NPI assigned
Jan 23, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
8107WIMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8107 WI Yes

Addresses

Primary practice location

138 2ND Ave N
Park Falls, WI 54552-1214

Mailing address

138 2ND Ave N
Park Falls, WI 54552-1214
Phone (715) 762-3283

Other providers in Park Falls, WI

All providers in Park Falls, WI · Pharmacist in Wisconsin

Sources for this page

Verify at the official NPI Registry.