Provider Demographics
NPI:1184276917
Name:ST. CLARE HEALTH MISSION PHARMACY
Entity type:Organization
Organization Name:ST. CLARE HEALTH MISSION PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARFSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:608-519-4621
Mailing Address - Street 1:916 FERRY ST
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-4717
Mailing Address - Country:US
Mailing Address - Phone:608-519-4621
Mailing Address - Fax:608-519-4612
Practice Address - Street 1:916 FERRY ST
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4717
Practice Address - Country:US
Practice Address - Phone:608-519-4621
Practice Address - Fax:608-519-4612
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CLARE HEALTH MISSION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy