Provider Demographics
NPI:1225130032
Name:PHARMACARE LTD
Entity Type:Organization
Organization Name:PHARMACARE LTD
Other - Org Name:OHDE HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDNET
Authorized Official - Prefix:
Authorized Official - First Name:BRANDIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-833-6770
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:CHETEK
Mailing Address - State:WI
Mailing Address - Zip Code:54728-0127
Mailing Address - Country:US
Mailing Address - Phone:715-924-3592
Mailing Address - Fax:715-924-2860
Practice Address - Street 1:628 2ND ST
Practice Address - Street 2:
Practice Address - City:CHETEK
Practice Address - State:WI
Practice Address - Zip Code:54728-9007
Practice Address - Country:US
Practice Address - Phone:715-924-3592
Practice Address - Fax:715-924-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33276500Medicaid
WI4657630005Medicare NSC