NPIMap

Dennis John Ballweg, R.PH.

Individual provider Active NPI Pharmacist · Prairie Du Sac, WI

NPI 1265785448 · NPPES record last updated Oct 24, 2012

Key facts

NPI
1265785448
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
11459 (WI)
Practice address
1200 Prairie St
Prairie Du Sac, WI 53578-2041
Phone
(608) 643-6500
Fax
(608) 643-6533
NPI assigned
Oct 24, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
11459WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ballweg Family Pharmacy Inc Current Accepting new patients
Ballweg Family Pharmacy Inc Current
since Jan 29, 2023		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11459 WI Yes

Addresses

Primary practice location

1200 Prairie St
Prairie Du Sac, WI 53578-2041

Mailing address

S9002 Woodford LN
Prairie Du Sac, WI 53578-9773
Phone (608) 643-5108

Other providers in Prairie Du Sac, WI

All providers in Prairie Du Sac, WI · Pharmacist in Wisconsin

Sources for this page

Verify at the official NPI Registry.