| NPI | 1316380785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE DRIZD Director Pharmacy Operations 262-532-5168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 9196-42) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2017-10-30 |