GWIDT PHARMACY INC
NPI: 1245319912
· OCONTO FALLS, WI 54154
· Pharmacy
· NPI assigned 11/03/2006
$572.40
Total Medicaid Paid
Provider Details
| Authorized Official | STARRY, TIMOTHY (PRESIDENT) |
| NPI Enumeration Date | 11/03/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
49 |
$572.40 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 0003A |
|
16 |
16 |
$572.40 |
| 91300 |
|
33 |
30 |
$0.00 |