| NPI | 1457604928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE DRIZD Director, Outpatient Pharmacy Opera 262-532-5168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 9162-42) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2018-04-20 |