Provider Demographics
NPI:1538899596
Name:MANITOWOC PHARMACIES INC
Entity type:Organization
Organization Name:MANITOWOC PHARMACIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:STARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-822-3011
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:WI
Mailing Address - Zip Code:54162-0200
Mailing Address - Country:US
Mailing Address - Phone:920-822-3011
Mailing Address - Fax:920-822-3852
Practice Address - Street 1:121 N SAINT AUGUSTINE ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:WI
Practice Address - Zip Code:54162-7982
Practice Address - Country:US
Practice Address - Phone:920-822-3011
Practice Address - Fax:920-822-3852
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANITOWOC PHARMACIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy