Provider Demographics
NPI:1649668286
Name:WOMEN'S INTERNATIONAL PHARMACY, INC.
Entity type:Organization
Organization Name:WOMEN'S INTERNATIONAL PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DISPENSING PHARMACISTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:608-221-7800
Mailing Address - Street 1:2 MARSH CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-8805
Mailing Address - Country:US
Mailing Address - Phone:800-279-5708
Mailing Address - Fax:800-279-8011
Practice Address - Street 1:12012 N 111TH AVE
Practice Address - Street 2:
Practice Address - City:YOUNGTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85363-1339
Practice Address - Country:US
Practice Address - Phone:800-742-0516
Practice Address - Fax:866-373-0030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMEN'S INTERNATIONAL PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-06
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336M0002X
AZY028793336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1990020OtherPK