Organization · Type 2 NPI

Beaver Dam Community Hospitals Inc

Pharmacy · Beaver Dam, WI

NPI number 1720202864 Active

Practice location

707 S University Ave
Beaver Dam, WI 53916-3027

Call (920) 887-4146 Map

Fax (920) 887-6613

Mailing address

1000 N Oak Ave, Attn: Provider Enrollment Services/wwp
Marshfield, WI 54449-5703

Specialties and licenses

Taxonomy	Code	License
General Acute Care Hospital	282N00000X	5344-042 (WV)
Pharmacy Primary	333600000X	None listed

Pharmacy: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is lo…

90 other providers at this address

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NPI record

NPI: 1720202864
Entity type: Organization (Type 2)
Issued: Apr 12, 2007
Last updated: Mar 7, 2023
Status: Active
Subpart: Yes of Marshfield Clinic Health System Inc

Other names

<unavail>
(inactive) Hillside Unit Pharmacy · doing business as
(inactive) Hillside Unit Pharmacy · doing business as

Authorized official

Gordon T Edwards
CFO/coo/ao
(715) 387-5823

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1720202864

Beaver Dam Community Hospitals Inc's National Provider Identifier is 1720202864, issued on Apr 12, 2007. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Beaver Dam, WI. The record was last updated on Mar 7, 2023.