Provider Demographics
NPI:1760949010
Name:T A SOLBERG CO INC
Entity Type:Organization
Organization Name:T A SOLBERG CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ATHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-479-6413
Mailing Address - Street 1:PO BOX 50
Mailing Address - Street 2:
Mailing Address - City:MINOCQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54548-0050
Mailing Address - Country:US
Mailing Address - Phone:715-479-6413
Mailing Address - Fax:715-479-4621
Practice Address - Street 1:662 N 4TH ST
Practice Address - Street 2:
Practice Address - City:TOMAHAWK
Practice Address - State:WI
Practice Address - Zip Code:54487-2123
Practice Address - Country:US
Practice Address - Phone:715-453-2741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T A SOLBERG CO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy