| NPI | 1578109161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAN NELSON SVP Of Financial Operations 414-299-1659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2021-04-06 |