| NPI | 1376570663 |
|---|---|
| Doing Business As | ISAAC COGGS HERITAGE HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | TITO IZARD President CEO 414-267-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: WI 8664042) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2016-09-16 |