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Forest County Potawatomi Community
Clinic Pharmacy in Crandon, Wisconsin
NPI 1750399630

Forest County Potawatomi Community is a Clinic Pharmacy based in Crandon, WI and is specialized in Clinic Pharmacy. Forest County Potawatomi Community practices in Crandon, WI. The NPI Number for Forest County Potawatomi Community is 1750399630 and holds a License No. (Wisconsin).

The current practice location address for Forest County Potawatomi Community is 8201 Mish Ko Swen Drive, Crandon, WI and can be reached out via phone at 715-478-4347 and via fax at 715-478-4409.

Location: 8201 Mish Ko Swen Drive, Crandon, WI, 54520-0396
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750399630
Provider Name
Forest County Potawatomi Community
Credential
Provider Entity Type
Organization
Address
8201 Mish Ko Swen Drive, Crandon, WI, 54520-0396
Phone Number
715-478-4347
Fax Number
715-478-4409
Provider Enumeration Date
08/04/2006
Last Update Date
12/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
32956600 05 WI
institution
Provider Business Practice Location Address Details
Address
8201 Mish Ko Swen Drive
City
Crandon
State
Wisconsin
Zip
54520-8631
Phone Number
715-478-4347
Fax Number
715-478-4409
person
Provider Business Mailing Address Details
Address
8201 Mish Ko Swen Drive
City
Crandon
State
Wisconsin
Zip
54520-8631
Phone Number
715-478-4347
Fax Number
715-478-4409
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
()
Definition
An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Clinic Pharmacy
Taxonomy
3336C0002X
License No.
()
Definition
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
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