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Contact Information

MODERN APOTHECARY, LLC
5700 6TH AVE
KENOSHA, WI53140-4104
 Phone: 262-997-9573
 Fax: 262-997-9574
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MODERN APOTHECARY, LLC

NPI # 1407265598
LBN Legal business name MODERN APOTHECARY, LLC
Authorized official ERIN MERRITT - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/04/2014
Last updated 01/31/2024 - About 2 years ago
Identifiers
WI License # 9274-42
Other 5134476 NCPDP NUMBER
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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