| NPI | 1154321602 |
|---|---|
| Doing Business As | CEDAR LAKE CAMPUS PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOSEPH T PICHLER Vice President Of Finance 262-306-4212 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WI 5115503) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WI 5115503) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2020-12-30 |