Community Memorial Hospital
Non-Pharmacy Dispensing Site in Gillett, WI. Organization (NPI-2).
NPI number1407186141
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1407186141
- Entity type
- Organization (NPI-2)
- Legal business name
- Community Memorial Hospital
- Organization subpart
- No
- Enumeration date
- Dec 31, 2009
- Certification date
- Dec 23, 2021
- Last updated
- Mar 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332900000X | Non-Pharmacy Dispensing Site | – | – | Yes |
Other names
- Cmh Primary Care Clinic, Remote Dispensing Registration (Other Name)
Practice location
340 N Green Bay AveGillett, WI 54124-9325
Phone 920-855-2823 · Fax 920-855-6343
Mailing address
340 N Green Bay AveGillett, WI 54124-9325
Phone 920-855-2823 · Fax 920-855-6343
Authorized official
Jason E Knox
Pharmacy Manager
9208463444
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