AGNESIAN HEALTHCARE ENTERPRISES LLC
912 S Hickory St
Fond Du Lac, WI 54935
920-929-7480
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0003X | Suppliers - Pharmacy - Community/Retail Pharmacy | WI | 8435-42 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
33283000 | WI | MEDICAID | |
PK | 2110220 | OTHER |