Moe Drugs LLC

Organization Active NPI Community/Retail Pharmacy · Three Lakes, WI

NPI 1104285907 · NPPES record last updated Feb 20, 2017

Key facts

NPI
1104285907
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
9400-42 (WI)
Legal business name
MOE DRUGS LLC
Practice address
1790 Superior St
Three Lakes, WI 54562-9046
Phone
(715) 546-3266
Fax
(715) 546-2912
NPI assigned
Feb 22, 2016
Organization subpart
No

Authorized official

Name
Seth Moe
Title
Pharmd
Phone
(920) 639-1384

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 9400-42 WI Yes

Addresses

Primary practice location

1790 Superior St
Three Lakes, WI 54562-9046

Mailing address

1790 Superior St
Three Lakes, WI 54562-9046
Phone (715) 546-3266

Other identifiers

IdentifierTypeStateIssuer
2158870OtherPK
100055480MedicaidWI

Other names

  • Three Lakes Pharmacy Doing business as

Other providers in Three Lakes, WI

All providers in Three Lakes, WI · Community/Retail Pharmacy in Wisconsin

Sources for this page

Verify at the official NPI Registry.