| NPI | 1104298595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE SHUDA Manager 414-308-3046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 18206-40) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |