Village Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Coleman, WI
NPI 1124031463 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1124031463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 8460 (WI)
- Legal business name
- VILLAGE PHARMACY INC
- Practice address
- 633 N Hwy 141
Box 186
Coleman, WI 54112-0186 - Phone
- (920) 897-5333
- Fax
- (920) 897-5451
- NPI assigned
- Aug 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Jeffrey Dean Hines, RPH
- Title
- Owner President
- Phone
- (920) 897-5333
Practitioners 3
-
Casey Jo Blom, PHARMD
-
Jeffrey Hines, RPH
-
Karen Hines, RPH
National Provider Directory
Locations
633 Highway 141
Coleman, WI 54112
Phone (920) 897-5333
633 Highway 141
#186
Coleman, WI 54112
Phone (920) 897-5333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 8460 | WI | Yes |
Addresses
Primary practice location
633 N Hwy 141
Box 186
Coleman, WI 54112-0186
Mailing address
633 N Hwy 141
Box 186
Coleman, WI 54112-0186
Phone (920) 897-5333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33257500 | Medicaid | WI | |
| 5126582 | Other | WI | NCPDP |
Other providers in Coleman, WI
All providers in Coleman, WI · Community/Retail Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.