Provider Demographics
NPI:1245741610
Name:M & J OF CUMBERLAND, INC.
Entity Type:Organization
Organization Name:M & J OF CUMBERLAND, INC.
Other - Org Name:THE APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BABKA-GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:715-822-2424
Mailing Address - Street 1:1470 WEBB ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54829-9187
Mailing Address - Country:US
Mailing Address - Phone:715-822-2424
Mailing Address - Fax:715-822-5470
Practice Address - Street 1:1470 WEBB ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:WI
Practice Address - Zip Code:54829-9187
Practice Address - Country:US
Practice Address - Phone:715-822-2424
Practice Address - Fax:715-822-5470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy