Provider Demographics
NPI:1730841115
Name:WINONA PHARMACIES LLC
Entity type:Organization
Organization Name:WINONA PHARMACIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/RPH
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:FUCHS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:208-733-4485
Mailing Address - Street 1:615 FILER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4008
Mailing Address - Country:US
Mailing Address - Phone:208-733-4485
Mailing Address - Fax:208-733-4186
Practice Address - Street 1:615 FILER AVE STE 2
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4008
Practice Address - Country:US
Practice Address - Phone:208-733-4485
Practice Address - Fax:208-733-4186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy