| NPI | 1386982957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHNSON Reimbursement Manager 262-928-4704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WI 9320-42) |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2022-12-14 |