Provider Demographics
NPI:1639263221
Name:PHARMACY OPERATIONS INC
Entity Type:Organization
Organization Name:PHARMACY OPERATIONS INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P. PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-325-1397
Mailing Address - Street 1:1 RIDER TRAIL PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EARTH CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63045-1313
Mailing Address - Country:US
Mailing Address - Phone:314-993-6000
Mailing Address - Fax:
Practice Address - Street 1:110 E OAK STREET
Practice Address - Street 2:
Practice Address - City:FREDERIC
Practice Address - State:WI
Practice Address - Zip Code:54837
Practice Address - Country:US
Practice Address - Phone:715-327-4208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8415-042333600000X
WI3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5116567OtherNCPDP #
WI33276300Medicaid
WI33276300Medicaid
WI000086781Medicare PIN
WI5116567OtherNCPDP #