Monica Thiry

Individual provider Active NPI Pharmacist · Casco, WI

NPI 1033539796 · NPPES record last updated Apr 21, 2014

Key facts

NPI
1033539796
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
13515-40 (WI)
Practice address
N7695 RR and LTL Rd
Casco, WI 54205-9754
Phone
(920) 837-7510
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13515-40WIMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13515-40 WI Yes

Addresses

Primary practice location

N7695 RR and LTL Rd
Casco, WI 54205-9754

Mailing address

N7695 RR and LTL Rd
Casco, WI 54205-9754
Phone (920) 837-7510

Other providers in Casco, WI

All providers in Casco, WI · Pharmacist in Wisconsin

Sources for this page

Verify at the official NPI Registry.