| NPI | 1568501609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DOUGLAS HERBST Owner/Pharmacist 262-363-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 5677042) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2016-06-27 |