| NPI | 1013963404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUDLEY BLANK Dir Of Pharm 414-906-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: WI 21799020) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2007-11-21 |