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Contact Information

PORT FAMILY PHARMACY, INC.
1021 N WISCONSIN ST
PORT WASHINGTON, WI53074-1207
 Phone: 262-261-3900
 Fax:
 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
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PORT FAMILY PHARMACY, INC.

NPI Number 1184353807
LBN Legal business name PORT FAMILY PHARMACY, INC.
Authorized official MICHAEL VINEBURG - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/08/2022
Last updated 05/04/2023 - About 3 years ago
Identifiers
WI Medicaid 100216135
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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