Provider Demographics
NPI:1962849315
Name:RASMUSSEN VILLAGE PHARMACY, INC.
Entity Type:Organization
Organization Name:RASMUSSEN VILLAGE PHARMACY, INC.
Other - Org Name:VILLAGE PHARMACY GLENWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:WILLINK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:715-684-2674
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:WI
Mailing Address - Zip Code:54002-0015
Mailing Address - Country:US
Mailing Address - Phone:715-684-2674
Mailing Address - Fax:715-684-4076
Practice Address - Street 1:224 OAK ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD CITY
Practice Address - State:WI
Practice Address - Zip Code:54013-4231
Practice Address - Country:US
Practice Address - Phone:715-684-2674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RASMUSSEN VILLAGE PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-24
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy