| NPI | 1619392420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WELDON W GAGE CFO/Treasurer 414-266-6401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 9244-42) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2014-03-03 |