Provider Demographics
NPI:1700025707
Name:ALLERGYCHOICES INC
Entity Type:Organization
Organization Name:ALLERGYCHOICES INC
Other - Org Name:ALLERGYCHOICES PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHEL
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARM
Authorized Official - Phone:608-793-1580
Mailing Address - Street 1:2731 NATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8784
Mailing Address - Country:US
Mailing Address - Phone:608-793-1580
Mailing Address - Fax:608-793-1571
Practice Address - Street 1:2731 NATIONAL DR
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8784
Practice Address - Country:US
Practice Address - Phone:608-793-1580
Practice Address - Fax:608-793-1571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9342-423336C0004X, 3336S0011X
3336M0002X
WI8984-423336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2118902OtherPK