| NPI | 1154597292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PERHACH Business Manager 414-805-6531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 8837-42) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2020-01-30 |