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A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist | |
Institutional Pharmacy |
3336I0012X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1649576364 |
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| LBN Legal business name | WADE J DAHLBERG SR | ||||||||
| Authorized official | WILLIAM DAHLBERG - (OPERATION MGT) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 01/27/2011 | ||||||||
| Last updated | 02/07/2011 - About 15 years ago | ||||||||
| Identifiers |
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WADE J DAHLBERG SR
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WADE J DAHLBERG SR