NPI: 1093089500 · BALSAM LAKE, WI 54810 · Community/Retail Pharmacy · NPI assigned 03/01/2012
| Authorized Official | LUNDQUIST, ANITA (MANAGING PHARMACIST) |
| NPI Enumeration Date | 03/01/2012 |
Other providers sharing the same authorized official: LUNDQUIST, ANITA
| Provider | City | State | Total Paid |
|---|---|---|---|
| FREDERIC PHARMACY LLC | FREDERIC | WI | $1K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 13 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 91300 | 13 | 12 | $0.00 |