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Contact Information

KEALEY PHARMACY & HOME CARE CENTER
21 S JACKSON ST
JANESVILLE, WI53548-3859
 Phone: 608-752-7869
 Fax: 608-752-6806
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for KEALEY PHARMACY & HOME CARE CENTER

NPI Number 1033243845
LBN Legal business name KEALEY PHARMACY & HOME CARE CENTER
Authorized official MARK JOHNSON - (OWNER / PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/15/2007
Last updated 06/14/2013 - About 13 years ago
Identifiers
WI License # 7301-042
WI Medicaid 33117200
Other 2111847 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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