National Provider Identifier Database

PHARMACY HOLDING COMPANY OF WISCONSIN LLC
Compounding Pharmacy

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner?s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.


Contact Information

PHARMACY HOLDING COMPANY OF WISCONSIN LLC
1256 OLD 51 S
ARBOR VITAE, WI54568-9793
Phone: 715-358-4070
Fax: 715-358-4072
Website:
Specialty Taxonomy Code
* Compounding Pharmacy 3336C0004X
Mail Order Pharmacy 3336M0002X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for PHARMACY HOLDING COMPANY OF WISCONSIN LLC

NPI Number 1003175266
Legal business name
LBN
PHARMACY HOLDING COMPANY OF WISCONSIN LLC
Authorized official CHERYL HULL - (OWNER/MEMBER)
Entity Organization
Organization subpart No
Enumeration date 05/09/2012
Last updated 02/22/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: PH25982
  • MS License #: 11215/7.1
  • NE License #: 696
  • WI License #: 9082-042
  • Other: 5133169 NCPDP PROVIDER IDENTIFICATION NUMBER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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