Organization · Type 2 NPI

Thedacare Medical Center - Wild Rose, Inc

Non-Pharmacy Dispensing Site · Wild Rose, WI

NPI number 1679095293 Active

Practice location

601 Grove Ave
Wild Rose, WI 54984-6903

Fax (920) 622-6021

Mailing address

6501 City West Pkwy
Eden Prairie, MN 55344-3248

Specialties and licenses

TaxonomyCodeLicense
Non-Pharmacy Dispensing Site Primary 332900000X1004 (WI)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

13 other providers at this address

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About NPI 1679095293

Thedacare Medical Center - Wild Rose, Inc's National Provider Identifier is 1679095293, issued on Jul 14, 2017. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Wild Rose, WI. The record was last updated on Jan 3, 2024.